[Evaluation of antimicrobial schemes in episodes of fever and granulocytopenia in children with cancer].

The efficacy of two antibiotic regimens used as initial empiric therapy was evaluated in 299 episodes of fever and granulocytopenia in children with cancer. Of these, 148 were treated with the combination cefoxitin-amikacin-carbenicillin and the remaining 151 with ceftriaxone-amikacin. All of the patients were evaluated at the beginning and 72 hours after starting treatment with laboratory tests and based on their clinical condition. Each was classified according to the type of infection. A few modifications were made to the initial treatment plan and in accordance with the clinical condition of each patient. Over 52% of the episodes were due to fever of unknown origin and 47.2% due to infections, of which 33.8% proved to be positive blood cultures mainly for Staphylococcus aureus and Pseudomonas aeruginosa. The modifications made to the basic treatment regimens were the addition of amphotericin B, clindamycin or vancomycin. An 89.2% therapeutic index percentage was obtained, independent from the use of either antibiotic scheme. The total therapeutic index for the study was 83.6%.