Restricted use of glycopeptides in paediatric cancer patients with fever and neutropenia

Simon, Arne; Gröger, Nora; Wilkesmann, Anja; Hasan, Carola; Wiszniewsky, Gertrud; Engelhart, Steffen; Kramer, Michael H; Bode, Udo; Ammann, Roland A; Fleischhack, Gudrun (2006). Restricted use of glycopeptides in paediatric cancer patients with fever and neutropenia. International journal of antimicrobial agents, 28(5), pp. 417-22. Amsterdam: Elsevier 10.1016/j.ijantimicag.2006.08.007

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Until now, studies confirming the safety of glycopeptide restriction in the empirical treatment of prolonged fever and neutropenia included only nine children. In an open-label observational study, the use of teicoplanin in paediatric oncology patients was investigated. A period of unrestricted use (2001-2003) was compared with a second period (2004) following implementation of a restrictive treatment guideline. Empirical first-line treatment consisted of piperacillin/tazobactam; in 2004, fosfomycin was added after 72 h as the second-line combination instead of teicoplanin. In total, 213 episodes (n=163 in 2001-2003; n=50 in 2004) managed with teicoplanin or fosfomycin (only 2004) were eligible. Empirical treatment of fever of unknown origin with teicoplanin was reduced by 97%. In 2004, the mean length of stay was 0.4 days shorter, no infection-related death occurred and no vancomycin-resistant enterococci were detected. Restriction of empirical glycopeptides is safe in paediatric cancer patients after first-line treatment with piperacillin/tazobactam. Fosfomycin appears to offer a feasible and cost-saving alternative in second-line combination therapy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Ammann, Roland

ISSN:

0924-8579

ISBN:

17046210

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:48

Last Modified:

17 Mar 2015 21:48

Publisher DOI:

10.1016/j.ijantimicag.2006.08.007

PubMed ID:

17046210

Web of Science ID:

000242653600008

URI:

https://boris.unibe.ch/id/eprint/20003 (FactScience: 3082)

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