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.
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 pneumoniaamphotericin 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.
Authors: A Cometta; T Calandra; H Gaya; S H Zinner; R de Bock; A Del Favero; G Bucaneve; F Crokaert; W V Kern; J Klastersky; I Langenaeken; A Micozzi; A Padmos; M Paesmans; C Viscoli; M P Glauser Journal: Antimicrob Agents Chemother Date: 1996-05 Impact factor: 5.191
Authors: G Maschmeyer; H Link; W Hiddemann; P Meyer; M Helmerking; E Eisenmann; J Schmitt; D Adam Journal: Cancer Date: 1994-05-01 Impact factor: 6.860
Authors: A G Freifeld; T Walsh; D Marshall; J Gress; S M Steinberg; J Hathorn; M Rubin; P Jarosinski; V Gill; R C Young Journal: J Clin Oncol Date: 1995-01 Impact factor: 44.544
Authors: K S Schwab; C Hahn-Ast; W J Heinz; U Germing; G Egerer; A Glasmacher; C Leyendecker; G Marklein; C M Nellessen; P Brossart; M von Lilienfeld-Toal Journal: Infection Date: 2013-08-25 Impact factor: 3.553