Premium
Evaluation of Empiric Vancomycin Therapy in Children with Fever and Neutropenia
Author(s) -
Adcock Kim G.,
Akins Ronda L.,
Farrington Elizabeth A.
Publication year - 1999
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.19.16.1315.30867
Subject(s) - empiric therapy , medicine , neutropenia , vancomycin , intensive care medicine , antibiotic therapy , pediatrics , antibiotics , chemotherapy , microbiology and biotechnology , staphylococcus aureus , alternative medicine , pathology , biology , bacteria , genetics
A retrospective evaluation was conducted to determine which children admitted for fever and neutropenia required empiric vancomycin therapy, and to develop a clinical pathway for appropriate treatment. Chart review identified 109 admissions of 36 pediatric oncology patients for fever and neutropenia, of which 88 were eligible for analysis. Blood cultures isolated 17 gram‐positive organisms; coagulase‐negative staphylococci and viridans group streptococci were cultured most frequently (82%). We concluded that previous high‐dose cytarabine therapy, inflamed central access site, and hypotension or septic shock are possible indicators of febrile, neutropenic patients at high risk for gram‐positive pathogen isolation. These predictors then were used to determine which children would receive empiric vancomycin therapy.