Document Detail

Trimethoprim-sulfamethoxazole salvage for refractory listeriosis during maintenance chemotherapy for acute lymphoblastic leukemia.
MedLine Citation:
PMID:  10959905     Owner:  NLM     Status:  MEDLINE    
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.
P Wacker; H Ozsahin; A H Groll; A Gervaix; L Reinhard; J Humbert
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of pediatric hematology/oncology     Volume:  22     ISSN:  1077-4114     ISO Abbreviation:  J. Pediatr. Hematol. Oncol.     Publication Date:    2000 Jul-Aug
Date Detail:
Created Date:  2000-08-31     Completed Date:  2000-08-31     Revised Date:  2011-10-06    
Medline Journal Info:
Nlm Unique ID:  9505928     Medline TA:  J Pediatr Hematol Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  340-3     Citation Subset:  IM    
Department of Pediatrics, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
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MeSH Terms
Aminoglycosides / therapeutic use
Amoxicillin / therapeutic use
Anti-Infective Agents / therapeutic use*
Antineoplastic Combined Chemotherapy Protocols / adverse effects,  therapeutic use
Bacteremia / drug therapy*
Gentamicins / therapeutic use
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*
Reg. No./Substance:
0/Aminoglycosides; 0/Anti-Infective Agents; 0/Gentamicins; 0/Penicillins; 26787-78-0/Amoxicillin; 8064-90-2/Trimethoprim-Sulfamethoxazole Combination

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