Estudio de la efectividad de Cefepime en pacientes adultos con bacteriemia en neutropenia febril, Instituto Oncológico Nacional SOLCA Dr. Juan Tanca Marengo 2010 - 2011
Fecha
2012
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La neutropenia febril es la complicación infecciosa más frecuente que presentan los pacientes con patologías oncológicas, y que amerita un tratamiento de urgencia para evitar la mortalidad que induce el bajo recuento celular. En la actualidad se dispone de una serie de antibióticos de amplio espectro, que han sido protocolizados en cada centro hospitalario, y el Instituto Oncológico Nacional de la Sociedad de Lucha contra el Cáncer del Ecuador, promulga el empleo inicial del cefepime. Este criterio terapéutico tiene más de quince años de vigencia; y provocó la inquietud médica motivo de esta investigación, que buscaba identificar características locales de frecuencia, de aislamiento microbiológico, tiempo de resolución de la neutropenia y patrones de resistencia bacteriana frente al cefepime. Para esto se realizó un estudio descriptivo, no experimental, longitudinal, retrospectivo obtenido de los expedientes clínicos de los pacientes hospitalizados entre el 1 de enero de 2010 hasta el 31 de diciembre de 2011, quienes presentaron neutropenia febril, se realizaron hemocultivos y recibieron como terapia antibiótica inicial al cefepime. Con el fin de presentar la información se empleó la observación dirigida mediante el uso de un formulario diseñado para el efecto. Los resultados de este estudio demostraron que el cefepime presenta el 74% de efectividad como antibiótico empírico inicial en neutropenia febril con bacteriemia, incluso cubriendo al 30% de los episodios que no evidencian un proceso infeccioso y actuando frente a bacterias gramnegativas, a excepción del género Serratia, frente al cual presenta resistencia absoluta
Neutropenia febrile is the most common infectious complication experienced by patients with oncological diseases, and deserves urgent treatment to prevent mortality induced by the low cell count. At present it has a number of broad-spectrum antibiotics, which have been officially recorded in each hospital, and the National Cancer Institute of the Society of Anti-Cancer of Ecuador, has docketed cefepime initial employment. This protocol has over fifteen years of existence, and caused health concerns because of this research that seeks to identify local frequency characteristics, microbiological isolation, time to resolution of neutropenia, and identify patterns of bacterial resistance to cefepime. For this will be a descriptive, non-experimental, longitudinal, retrospective obtained of medical records of patients hospitalized between January 1, 2010 until December 31, 2011, who presented febrile neutropenia, blood cultures were made and received as cefepime initial therapy. In order to present the information was used observation addressed by using a form designed for that purpose. The results of this study showed that cefepime has 74% effective as initial empiric antibiotic with bacteremia in febrile neutropenia, even covering 30% of the episodes that do not reveal an infectious process and acting against Gram-negative bacteria, except for gender Serratia, which is resistant against absolute
Neutropenia febrile is the most common infectious complication experienced by patients with oncological diseases, and deserves urgent treatment to prevent mortality induced by the low cell count. At present it has a number of broad-spectrum antibiotics, which have been officially recorded in each hospital, and the National Cancer Institute of the Society of Anti-Cancer of Ecuador, has docketed cefepime initial employment. This protocol has over fifteen years of existence, and caused health concerns because of this research that seeks to identify local frequency characteristics, microbiological isolation, time to resolution of neutropenia, and identify patterns of bacterial resistance to cefepime. For this will be a descriptive, non-experimental, longitudinal, retrospective obtained of medical records of patients hospitalized between January 1, 2010 until December 31, 2011, who presented febrile neutropenia, blood cultures were made and received as cefepime initial therapy. In order to present the information was used observation addressed by using a form designed for that purpose. The results of this study showed that cefepime has 74% effective as initial empiric antibiotic with bacteremia in febrile neutropenia, even covering 30% of the episodes that do not reveal an infectious process and acting against Gram-negative bacteria, except for gender Serratia, which is resistant against absolute
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Oncología médica, Neutropenia febril, Bacteriemia, Cefalosporina, Hospital SOLCA de Guayaquil, Cantón Guayaquil, Ecuador