Three-step empiric treatment for severely neutropenic patients with fever: Ceftazidime — Vancomycin — Amphotericin B
| Autor: | H. Koeppler, Klaus Havemann, R. Seitz, K. H. Pflueger |
|---|---|
| Rok vydání: | 1989 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty Neutropenia Adolescent Fever medicine.drug_class medicine.medical_treatment Antibiotics Ceftazidime Antineoplastic Agents Pharmacotherapy Vancomycin Amphotericin B Internal medicine medicine Humans Prospective Studies Prospective cohort study Chemotherapy business.industry General Medicine Middle Aged medicine.disease Infectious Diseases Anesthesia Drug Therapy Combination Female business Agranulocytosis medicine.drug |
| Zdroj: | Infection. 17:142-145 |
| ISSN: | 1439-0973 0300-8126 |
| DOI: | 10.1007/bf01644013 |
| Popis: | In a prospective study 50 febrile episodes in severely neutropenic patients (neutrophils less than 500/mm3) were empirically treated with ceftazidime monotherapy. If no response was seen after 48 h, vancomycin was added. After another 72 h period, patients with persisting fever additionally received amphotericin B. In 29 episodes (58%) patients became afebrile with ceftazidime monotherapy. Another seven patients (14%) responded to the addition of vancomycin and five patients (10%) needed amphotericin B to become afebrile. A success of the study drugs without modification was seen in 40 episodes (80%), success with modification in three episodes (6%) and failure in six episodes (12%). One patient died of myocardial infarction. No other death occurred during the two-week observation period after entering the study. Though there were two gram-negative isolates resistant to ceftazidime, these patients were successfully treated with modification. It is concluded that the response-adapted additive sequence of ceftazidime, vancomycin and amphotericin B is an effective approach towards febrile episodes in severely neutropenic patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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