La neutrop\u00e8nia febril \u00e9s una complicaci\u00f3 que es produeix sovint en pacients amb malalties onco-hematol\u00f2giques que estan rebent quimioter\u00e0pia o trasplantament de c\u00e8l\u00b7lules mare. Es tracta d’un s\u00edndrome complex on nom\u00e9s un 20-30% dels pacients mostren signes cl\u00ednics o microbiol\u00f2gics d’infecci\u00f3, i aproximadament el 20% tenen bacteri\u00e8mia. A m\u00e9s, en els \u00faltims anys, s’ha observat en aquest grup de pacients vulnerables un augment de les infeccions causades per bacteris gramnegatius, aix\u00ed com l’aparici\u00f3 de resist\u00e8ncia als antibi\u00f2tics.<\/p>\n
El tractament de la neutrop\u00e8nia febril es basa principalment en l’\u00fas d’antibi\u00f2tics beta-lact\u00e0mics. En aquest sentit, s’ha demostrat que l’\u00fas de perfusions intravenoses prolongades d’aquests antibi\u00f2tics millora els resultats en pacients cr\u00edtics de les unitats de cures intensives. Aix\u00f2 es deu al fet que, amb les infusions prolongades, l’antibi\u00f2tic mant\u00e9 una concentraci\u00f3 efica\u00e7 durant m\u00e9s temps per combatre els microorganismes responsables de la infecci\u00f3. No obstant aix\u00f2, encara hi ha controv\u00e8rsia sobre els beneficis potencials d’aquesta t\u00e8cnica en pacients amb neutrop\u00e8nia febril.<\/p>\n
Una recent metaan\u00e0lisi ha proporcionat dades importants sobre aquest tema. S’han revisat els resultats de cinc estudis, dos dels quals eren assajos cl\u00ednics aleatoritzats, amb un total de 691 episodis de neutrop\u00e8nia febril. S\u2019han comparat els efectes de l’\u00fas d’antibi\u00f2tics beta-lact\u00e0mics en infusions intermitents amb les infusions prolongades. La conclusi\u00f3 de l\u2019an\u00e0lisi \u00e9s que de moment no es pot demostrar que les infusions prolongades aconsegueixin reduir la mortalitat, ni altres aspectes com la baixada de la febre, l’\u00fas de medicaments vasoactius, la durada de l’hospitalitzaci\u00f3 o els efectes adversos.<\/p>\n
Per aquest motiu, de moment, no es pot recomanar l\u2019\u00fas generalitzat de la perfusi\u00f3 estesa de beta-lact\u00e0mic com a tractament emp\u00edric de la neutrop\u00e8nia febril, i s\u00f3n necessaris m\u00e9s assajos cl\u00ednics per determinar si hi ha subgrups de pacients amb aquesta malaltia que es poden beneficiar d’una infusi\u00f3 prolongada d\u2019aquests antibi\u00f2tics.<\/p>\n
<\/p>\n
<\/p>\n
L\u2019Institut d’Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) \u00e9s un centre de recerca en biomedicina creat l\u2019any 2004. Est\u00e0 participat per l’Hospital Universitari de Bellvitge i l\u2019Hospital de Viladecans de l’Institut Catal\u00e0 de la Salut, l’Institut Catal\u00e0 d’Oncologia, la Universitat de Barcelona i l\u2019Ajuntament de l\u2019Hospitalet de Llobregat.<\/em><\/p>\n L\u2019IDIBELL \u00e9s membre del Campus d’Excel\u00b7l\u00e8ncia Internacional de la Universitat de Barcelona HUBc i forma part de la instituci\u00f3 CERCA de la Generalitat de Catalunya. L’any 2009 es va convertir en un dels cinc primers centres d\u2019investigaci\u00f3 espanyols acreditats com a institut d\u2019investigaci\u00f3 sanit\u00e0ria per l\u2019Instituto de Salud Carlos III. A m\u00e9s, forma part del programa \u201cHR Excellence in Research\u201d de la Uni\u00f3 Europea i \u00e9s membre de EATRIS i REGIC. Des de l\u2019any 2018, l\u2019IDIBELL \u00e9s un Centro Acreditado de la Fundaci\u00f3n Cient\u00edfica AECC (FCAECC).<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" S’han revisat els resultats de cinc estudis, dos dels quals eren assajos cl\u00ednics aleatoritzats, amb un total de 691 episodis de neutrop\u00e8nia febril. S\u2019han comparat els efectes de l’\u00fas d’antibi\u00f2tics beta-lact\u00e0mics en infusions intermitents amb les infusions prolongades<\/p>\n","protected":false},"author":8,"featured_media":24071,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[1],"tags":[],"publishpress_future_action":{"enabled":false,"date":"2024-05-25 03:27:06","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"_links":{"self":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/24070"}],"collection":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/comments?post=24070"}],"version-history":[{"count":1,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/24070\/revisions"}],"predecessor-version":[{"id":24072,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/24070\/revisions\/24072"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media\/24071"}],"wp:attachment":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media?parent=24070"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/categories?post=24070"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/tags?post=24070"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}