Piperacillin/tazobactam in continuous infusion versus intermittent infusion in children with febrile neutropenia
Por:
Solórzano-Santos F., Quezada-Herrera A., Fuentes-Pacheco Y., Rodríguez-Coello G., Aguirre-Morales C.E., Izelo-Flores D., Muñoz-Hernández O., Miranda-Novales M.G.
Publicada:
1 ene 2019
Categoría:
Medicine (miscellaneous)
Resumen:
Background: Febrile neutropenia (FN) is a common complication in children who receive chemotherapy for cancer. Objective: The objective of this study was to evaluate the clinical efficacy of the continuous versus intermittent infusion of piperacillin/ tazobactam (TZP) in febrile neutropenic pediatric patients. Methods: This is a non-blinded randomized controlled clinical trial. Eligible group consisted of hemato-oncological patients with FN who were candidates to receive TZP. Patients were randomized to one of two groups: Group 1 received antibiotic treatment through intravenous intermittent infusion of TZP 300 mg/kg/day based on piperacillin, divided into four doses, not exceeding 16 g/day; Group 2 received an initial TZP loading dose of 75 mg/kg infusion over 30 min, and then a continuous infusion of TZP 300 mg/kg/day through central line with pump over 24 h. Results: There were 176 episodes that could be assessed, 100 in Group 1 and 76 in Group 2. There was no statistically significant difference in treatment failure in the experimental group (continuous infusion) compared with the intermittent group, 21% versus 13% (p = 0.15). The increase in the absolute risk reduction was 0.08% (95% confidence interval 0.12-0.30), and the number needed to treat was 12.4. One patient in each group died. Conclusions: There were no differences in fever resolution, clinical cure rate, or mortality when comparing the continuous with the intermittent TZP infusion. © 2019 Instituto Nacional de la Nutricion Salvador Zubiran. All rights reserved.
Filiaciones:
Solórzano-Santos F.:
Research Unit in Evidence-Based Medicine, Hospital Infantil De Mexico Federico Gómez, Mexico City, Mexico
Quezada-Herrera A.:
Hospital del Niño y del Adolescente Morelense, Morelos, Mexico
Fuentes-Pacheco Y.:
High Specialty Medical Unit, Hospital de Pediatría, CMN SXXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
Rodríguez-Coello G.:
Hospital para el Niño Poblano, Secretaría de Salud, Puebla de Zaragoza, Puebla, Mexico
Aguirre-Morales C.E.:
Centro Médico ABC, Mexico City, Mexico
Izelo-Flores D.:
Hospital General de Zona No. 20, Instituto Mexicano del Seguro Social, Puebla, Mexico
Muñoz-Hernández O.:
Research Directorate, Hospital Infantil de México "Federico Gómez", SSA, Mexico City, Mexico
Miranda-Novales M.G.:
Unidad de Investigación en Análisis y Síntesis de la Evidencia Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social, Av. Cuauhtémoc, 330 Col. Doctores, Del. Cuauhtémoc, Mexico City, CP. 06720, Mexico
|