Agranulocytosis medical therapy: Difference between revisions
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==Overview== | |||
==Medical Therapy== | |||
In patients that have no symptoms of infection, management consists of close monitoring with serial [[blood counts]], withdrawal of the offending agent (e.g., medication), and general advice on the significance of fever. | |||
Infection in patients with low [[white blood cell]] counts is usually treated urgently, and usually includes a broad-spectrum penicillin ([[piperacillin-tazobactam]] or [[Timentin|ticarcillin clavulanate]]) or cephalosporin ([[ceftazidime]]), or [[meropenem]] in combination with [[gentamicin]] or [[amikacin]].{{Citation needed|date=February 2007}} | |||
If the patient remains febrile after 4–5 days and no causative organism for the infection has been identified, antibiotics are, in general, changed to a glycopeptide (e.g., [[vancomycin]]), and subsequently an antifungal agent (e.g., [[amphotericin B]]) is added to the regimen.{{Citation needed|date=February 2007}} In agranulocytosis, the use of recombinant G-CSF ([[filgrastim]]) often results in hematologic recovery.{{Citation needed|date=February 2007}} | |||
[[Blood transfusion|Transfusion]] of granulocytes would have been a solution to the problem. However, granulocytes live only ~10 hours in the circulation (for days in [[spleen]] or other tissue), which gives a very short-lasting effect. In addition, there are many complications of such a procedure. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 16:00, 21 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
In patients that have no symptoms of infection, management consists of close monitoring with serial blood counts, withdrawal of the offending agent (e.g., medication), and general advice on the significance of fever.
Infection in patients with low white blood cell counts is usually treated urgently, and usually includes a broad-spectrum penicillin (piperacillin-tazobactam or ticarcillin clavulanate) or cephalosporin (ceftazidime), or meropenem in combination with gentamicin or amikacin.[citation needed]
If the patient remains febrile after 4–5 days and no causative organism for the infection has been identified, antibiotics are, in general, changed to a glycopeptide (e.g., vancomycin), and subsequently an antifungal agent (e.g., amphotericin B) is added to the regimen.[citation needed] In agranulocytosis, the use of recombinant G-CSF (filgrastim) often results in hematologic recovery.[citation needed]
Transfusion of granulocytes would have been a solution to the problem. However, granulocytes live only ~10 hours in the circulation (for days in spleen or other tissue), which gives a very short-lasting effect. In addition, there are many complications of such a procedure.