amoxicillin-potassium-clavulanate-combination and Hematologic-Neoplasms

THE CONTEXT: Up until the nineties, the intravenous administration of a broad spectrum antibiotic was the classical treatment of any patient presenting with febrile neutropenia. Since then, in patients considered at low risk and with expected of neutropenia less than 7-10 days, oral antibiotherapy has become an attractive option. TWO LARGE STUDIES: A study by the antimicrobial group of the EORTC (European organisation for research and treatment of cancer) and a North American study have compared the efficacy of an oral combination of ciprofloxacine and amoxicillin/clavulanic acid with that of an intravenous antibiotherapy in low-risk patients presenting febrile neutropenia. In both studies, the success rate was the same in the group of patients treated with oral antibiotics and those treated with intravenous antibiotics. RESERVATIONS: These two studies were conducted in hospitalised patients. No conclusions can be drawn with regard to out-patient treatment. Out-patient management would only be possible after appropriate selection of patients at low risk.

Topics: Administration, Oral; Amoxicillin-Potassium Clavulanate Combination; Bacterial Infections; Ceftazidime; Ciprofloxacin; Drug Therapy, Combination; Europe; Fever; Hematologic Neoplasms; Humans; Immunocompromised Host; Infusions, Intravenous; Inpatients; Multicenter Studies as Topic; Neoplasms; Neutropenia; Randomized Controlled Trials as Topic; Risk; Treatment Outcome; United States