Çocukluk çağındaki nötropenik sepsis tedavisinde sefepimin etkinliğinin seftazidim ile karşılaştırılması

Bu çalışmada nötropenik sepsisli çocuklarda sefepim + amikasin ampirik kullanımının etkinliği prospektif, rastgele örnekleme yöntemi kullanılarak araştırıldı. Otuz iki nötropenik sepsisli hasta çalışmaya alındı ve iki gruba bölündü. Grup I yaşları 6-14 (8,3±3) arası olan 16 çocuktan, grup II ise yaşları 5-17 (6,7+5,2) olan 16 çocuktan oluşmakta idi. Grup I'deki hastalara sepefim 100mg/kg/gün iki dozda ve amikasin 15mg/kg/gün tek dozda, grup II' deki hastalara ise seftazidim 40mg/kg/gün dört dozda ve amikasin 15mg/kg/gün tek dozda ampirik uygulandı. Vankomisin veya amfoterisin B ilave edilmeksizin ateşin normale dönme oranı grup I'de %50, grup II'de % 37 idi. Her iki tedavi grubunda bakteriyel eradikasyon oranı % 75 idi. Her iki grup ateş ve nötropeni periyodu yönünden karşılaştırıldı. Gruplar arasında ateş ve nötropeni periyodu yönünden anlamlı farklılık görülmemesine rağmen (p>0,05), sefepim + amikasin tedavisi alan grup daha kısa ateş ve nötropeni periyoduna sahip idi. Sonuç olarak nötropenik sepsisli çocukların tedavisinde ampirik olarak sefepim kullanımının seftazidim kadar etkili ve güvenli olduğunu düşünmekteyiz.

The comparation efficiency of cefepime versus ceftazidime at the patients with neutropenic sepsis in childhood

This prospective and randomized trial was performed to evaluate the effect of empiric using Cefepime and Amikacin in children with neutropenic septicaemia. Thirty two febrile neutropenic patients were included into the study and divided into two groups. The patients in Group I (n = 16) were aged between 6-14 (8.3$\pm$3) years, and the patients the patients in Group II (n = 16) aged between 5-17 (6.7±5.2) years. Cefepime (100mg/kg/d,q12h plus Amikacin (15mg/kg/d, q12h were empirically given to the patients in group I, and Ceftazidime (40 mg/kg/d, q6h) plus Amikacin (15 mg/kg/d, q12h to the patients in group II. The fever decreasing response rates to both therapies were 50% in Group I and 37% in Group II without adding vancomycine or amphotericine-B. The bacterial eradication rates were 75% in each grouup. Both groups were compared with the criteria of "Fever Period" and "Neutropenia Period". Although, significant differences were not found between Fever Period and Neutropenia Period of Groups (p>0.05), the patients in cefepime+amikacin groups showed shorter Fever Period and Neutropenia Period. In conclusion; we think that empiric use of Cefepime is as effective and safe as ceftazidime in the treatment of febrile neutropenic children.

Kaynakça

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Kaynak Göster

  • ISSN: 1302-1923
  • Yayın Aralığı: Yılda 0 Sayı
  • Başlangıç: 2018

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