Περίληψη:
Background:
The aim of this study was to determine the safety, tolerance and
efficacy of linezolid for the treatment of infections from Gram-positive
bacteria in immunocompromised children with cancer.
Methods:
This was a prospective non-comparative unblinded study in the
Hematology/Oncology Unit over a two-year period, administering linezolid
as monotherapy in children with cancer.
Results:
Seventeen children received linezolid (30 mg/kgr: 3 i.v. per day). Mean
duration of linezolid administration was 12.2 days (range, 6-38 days),
while the median age of the evaluable patients was 2.2 years (range, 6
months-11.2 years). Primary diagnosis was acute lymphoblastic leukemia
(nine patients), brain tumor (three patients), multi-organ Langerhans
cell histiocytosis (two patients), rhabdomyosarcoma, Burkitt’s lymphoma
and ovarian tumor (one patient each). All patients were in the midst of
chemotherapy cycles. Ten out of 17 children had positive blood cultures
(methicillin-resistant Staphylococcus aureus, four patients;
vancomycin-resistant Enterococcus, three patients; penicillin-resistant
Streptococcus pneumoniae, three patients), while seven of the 17 had
fever and vancomycin-resistant Enterococcus in stool cultures. All
patients were considered clinically cured after the end of the linezolid
regimen (100% efficacy). The main adverse events were thrombocytopenia
grade 1-3 and anemia grade 2-3 (four and two patients, respectively).
Chemotherapy-induced myelotoxicity (six patients) was not worsened
during linezolid therapy. No bleeding episodes were presented.
Self-limited diarrhea grade 1-2 was presented in four patients (mean
duration 2 days). The total adverse event rate was 23.5%; however,
there was no premature cessation of linezolid in any patient.
Conclusions:
Linezolid may be another effective and safe therapy to treat infections
from resistant Gram-positive bacteria in immunocompromised children,
even in young ages.
Συγγραφείς:
Moschovi, Maria
Trimis, Georgios
Tsotra, Maria
Chatzi,
Fotini
Karamolegou, Kalliopi
Santou, Antina
Tourkantoni,
Natalia
Chrousos, George
