Utilización de antiinfecciosos en pacientes con neutropenia febril sometidos a trasplante de médula ósea (TMO)

Resumen

Objective: To analyze the use of antiinfectious agents in the empirical treatment of febrile neutropenia in patients undergoing a bone marrow transplantation (BMT) and to evaluate its economic impact. Method: Prospective analysis of the pharmacotherapeutic profile of all the patients who underwent BMT in the Hospital Universitario Doce de Octubre during the year 2002, by obtaining the data about incidence of febrile neutropenia, employed antiinfectious therapy and treatment duration. Also a cost-evaluation study was made. Results: A total of 50 patients underwent BMT, presenting febrile neutropenia 45 of them (90%). The main schemes of initial empirical antibiotic treatment are varied, but all of them include a ß-lactamic with activity against Pseudomonas spp. associated with an aminoglycoside and/or a glycopeptide. The antiinfectious therapy was 49. 0% of the pharmacologic treatment's total cost. A total of 13 patients (26%) presented prolonged febrile neutropenia that made necessary the use of systemic intravenous antifungals, which were 32% of the total cost. Conclusions: Febrile neutropenia is a quite frequent complication occurring in 90% of patients that undergo BMT. It does not exist a common pattern of empirical antiinfectious treatment. Furthermore, its treatment supposes a high percentage of the total drug budget (valued in economic terms)