Trimethoprim-sulfamethoxazole salvage for refractory listeriosis during maintenance chemotherapy for acute lymphoblastic leukemia

Article Article scientifique Rapport de cas Trimethoprim-sulfamethoxazole salvage for refractory listeriosis during maintenance chemotherapy for acute lymphoblastic leukemia eng 2000 author Wacker Pierre 23992 author Ozsahin Ayse Hulya 121635 author Groll AH author Gervaix Alain 31715 author Reinhard Laurent 38980 author Humbert James Ronald 25322 340-343 10.1097/00043426-200007000-00011 10959905 1077-4114 A 5-year-old boy with acute lymphoblastic leukemia (ALL) and intolerance to oral trimethoprim-sulfamethoxazole (TMP/SMX) had Listeria monocytogenes bacteremia and meningitis develop during maintenance chemotherapy. Despite prompt administration of IV amoxicillin/gentamicin and microbiologic clearance of the bloodstream, the patient had no response to therapy after a course of 7 days. Intravenous TMP/SMX (10 mg/kg per day of TMP) was added to the antibiotic regimen after desensitization. Fever and meningeal signs rapidly resolved, and the patient was ultimately cured. Amoxicillin and gentamicin, although highly active and synergistic in vitro against L. monocytogenes, have limited intracellular penetration and activity. In contrast, TMP/SMX has bactericidal extracellular and intracellular activity against Listeria and excellent central nervous system penetration, and thus may be effective for the treatment of refractory listeriosis. Aminoglycosides/therapeutic use Amoxicillin/therapeutic use Anti-Infective Agents/therapeutic use Antineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic use Bacteremia/drug therapy Child Gentamicins/therapeutic use Humans Male Meningitis, Listeria/drug therapy Penicillin Resistance Penicillins/therapeutic use Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/drug therapy/microbiology Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy/microbiology Salvage Therapy Trimethoprim-Sulfamethoxazole Combination/therapeutic use Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 false 149 Etiologie des pneumonies et marqueurs inflammatoires chez l'enfant fébrile 183 Journal of pediatric hematology/oncology 22 4 aa993368-6f34-4ca6-886a-a6e4db05b421 Article (Published version) Restricted 340-343.pdf 879375 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

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Trimethoprim-sulfamethoxazole salvage for refractory listeriosis during maintenance chemotherapy for acute lymphoblastic leukemia	Journal of pediatric hematology/oncology			2000	574	1

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Reinhard, Laurent