Medizinische Klinik (Munich, Germany : 1983) · 1997
[Therapy of infections in patients with acute leukemia].
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Hiddemann W, Maschmeyer G, Link H, Helmerking M, Adam D
Аннотация
BACKGROUND: Infections are the major cause for treatment failure in acute leukemias. They mostly present as fever of unknown origin (FUO), a smaller but prognostically unfavorable group are pneumonias. The effective management of infectious complications requires a symptom and response adapted interventional strategy.
THERAPEUTICAL APPROACH: In case of FUO standard therapy consists of the two drug combination of aminoglycoside plus acylaminopenicillin or third generation cephalosporine. In case of non-response carbapenems and a glycopeptide should be applied and a systemic antifungal treatment must be initiated. In pneumonia amphotericin B should be added to antibiotics already initially. Potent single agents with a broad spectrum of activity as well as new antifungal drugs provide attractive perspectives for future evaluations.
CONCLUSIONS: By a consequent step-wise oscalating interventional treatment strategy infections in patients with acute leukemias can be successfully treated.
THERAPEUTICAL APPROACH: In case of FUO standard therapy consists of the two drug combination of aminoglycoside plus acylaminopenicillin or third generation cephalosporine. In case of non-response carbapenems and a glycopeptide should be applied and a systemic antifungal treatment must be initiated. In pneumonia amphotericin B should be added to antibiotics already initially. Potent single agents with a broad spectrum of activity as well as new antifungal drugs provide attractive perspectives for future evaluations.
CONCLUSIONS: By a consequent step-wise oscalating interventional treatment strategy infections in patients with acute leukemias can be successfully treated.