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

Groll, AH
Published in Journal of pediatric hematology/oncology. 2000, vol. 22, no. 4, p. 340-3
Abstract 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.
Keywords Aminoglycosides/therapeutic useAmoxicillin/therapeutic useAnti-Infective Agents/therapeutic useAntineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic useBacteremia/drug therapyChildGentamicins/therapeutic useHumansMaleMeningitis, Listeria/drug therapyPenicillin ResistancePenicillins/therapeutic usePrecursor B-Cell Lymphoblastic Leukemia-Lymphoma/drug therapy/microbiologyPrecursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy/microbiologySalvage TherapyTrimethoprim-Sulfamethoxazole Combination/therapeutic use
PMID: 10959905
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Research group Etiologie des pneumonies et marqueurs inflammatoires chez l'enfant fébrile (183)
(ISO format)
WACKER, Pierre et al. Trimethoprim-sulfamethoxazole salvage for refractory listeriosis during maintenance chemotherapy for acute lymphoblastic leukemia. In: Journal of pediatric hematology/oncology, 2000, vol. 22, n° 4, p. 340-3. doi: 10.1097/00043426-200007000-00011 https://archive-ouverte.unige.ch/unige:73057

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Deposited on : 2015-06-08

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