Clinical experience with three combination regimens for the treatment of high-risk febrile neutropenia
Küçük Resim Yok
Tarih
2006
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Acad Medicine Singapore
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Introduction: The objective of this study was to compare the safety and efficacy of ceftazidime (2 g every 8 h), piperacillin/tazobactam (4 g/500 mg every 6 h), and meropenem (1 g every 8 h), when combined with amikacin (15 mg/kg once daily), in the empirical treatment of high-risk febrile neutropenic episodes in patients with haematological malignancy. Materials and Methods: A prospective, comparative study designed in the haematology unit of a university hospital in Turkey. Results: A total of 89 febrile episodes in 60 neutropenic patients were treated; 29 febrile episodes in 23 patients with ceftazidime plus amikacin (group 1), 30 episodes in 25 patients with piperacillin/tazobactam plus amikacin (group 2), and 30 episodes in 25 patients with meropenem plus amikacin (group 3). The 3 groups were comparable in terms of age, sex, underlying malignancy, pretherapy neutrophil counts, duration of neutropenia and types of infections. Neutropenia, since the start of fever, persisted for >= 10 days in all of the episodes in the 3 study groups. Nearly all of the episodes were seen in patients with acute leukaemia. In 25.8% (23/89) of the febrile neutropenia episodes, an aetiologic organism was isolated, with gram-negative bacteria being the most commonly isolated. The success without modification rates were 34.5%, 30% and 36.7% for groups 1, 2 and 3, respectively (P > 0.05). After modification with a different class of antimicrobial therapy, the response rates increased to 65.5%, 63.3% and 70% for groups 1, 2 and 3, respectively (P > 0.05). The mean duration of treatment and the time to defervescence were also comparable in all groups. In all arms, side effects were minimal. Conclusions: It is concluded that the 3 regimens were equally effective and safe in the empirical treatment of high-risk febrile neutropenic episodes.
Açıklama
Anahtar Kelimeler
antibiotic therapy, haematological malignancy
Kaynak
Annals Academy of Medicine Singapore
WoS Q Değeri
Q3
Scopus Q Değeri
Q2
Cilt
35
Sayı
1
