LÉČBA FEBRILNÍCH NEUTROPENIÍ U NEMOCNÝCH SE SOLIDNÍMI NÁDORY

Treatment of Febrile Neutropenias in Patients with Solid Tumours

Background.
Febrile neutropenia (FN) is one of the most serious complications of anti-tumourous treatment calling for early diagnosis and intensive treatment. The objective of the trial was to recommend a standard procedure for the treatment of febrile neutropenia at their Oncological Clinic, based on analyses of attacks of febrile neutropenia and the current microbial situation. Methods and Results. In 1995 - 1997 in 30 patients (24 women, 6 men) 39 attacks of febrile neutropenia were treated. The age distribution of patients was within the range of 20 - 68 years, the mean age being 50 years. In the group patients with breast cancer predominated (14), soft tissue sarcomas (4), colorectal carcinoma (3), other diagnoses participated with 9 episodes. The analysis of the microbial situation was based on cultivation findings made in patients with attacks of FN. For empirical treatment of FN the authors use at combined treatment piperacillin-gentamicin or sultamicillin-cefpodoxim/or ciprofloxacin. If empirical treatment fails, therapy is based on the results of cultivation and the patient´s clinical condition. Growth factors are indicated for treatment only in FN complicated by mycotic infection, inflammatory pulmonary infiltrates or cardiopulmonary failure. Conclusions. The standard procedure in the treatment of FN should be broad spectrum bactericidial antibiotics. The use of growth factors is reserved for complicated episodes of FN.

Key words:
neutropenia, growth factors, antibiotic treatment, broad spectrum penicillin’s, aminoglycosides, solid tumours.