Empirical antimicrobial monotherapy in patients after high-dose chemotherapy and autologous stem cell transplantation: a randomised, multicentre trial
| Autor: | Bernd Dörken, Hermann Einsele, Georg Maschmeyer, Oliver A. Cornely, Tanja Bellaire, Gernot Reich, Michael Sandherr, Stefan W. Krause, Eckhard Thiel, Thomas Kubin |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Tazobactam Neutropenia Adolescent Fever medicine.medical_treatment Penicillanic Acid Antineoplastic Agents Hematopoietic stem cell transplantation Opportunistic Infections Gastroenterology Autologous stem-cell transplantation Internal medicine Neoplasms medicine Humans Prospective Studies Aged Piperacillin business.industry Hematopoietic Stem Cell Transplantation Hematology Meropenem Middle Aged medicine.disease Surgery Transplantation Tolerability Piperacillin/tazobactam Drug Therapy Combination Female Thienamycins business Febrile neutropenia medicine.drug |
| Zdroj: | British journal of haematology. 130(2) |
| ISSN: | 0007-1048 |
| Popis: | We report on 232 patients undergoing autologous haematopoietic stem cell transplantation (ASCT) entered into a multicentre, randomised trial comparing the efficacy and tolerability of meropenem (MPM) with that of piperacillin/tazobactam (P/T) as empirical antimicrobial first-line therapy for febrile neutropenia. In 27.6% of patients in the MPM group and 22.4% in the P/T group, therapy was initially supplemented with a glycopeptide for venous catheter infection or bacteraemia because of coagulase-negative staphylococci. Complete response rate after 72 h was 63.8% in the MPM group and 49.6% in the P/T group (P = 0.034). Overall complete response rate after treatment modification was 94.0% in the MPM group and 93.1% in the P/T group. Median time to defervescence was 2 d in the MPM group and 3 d in the P/T group. The most frequently isolated pathogens were Gram-positive cocci. Treatment was well tolerated in both groups. One patient (0.4%) died from infection. Empirical first-line therapy with MPM as well as with P/T is safe and effective in febrile episodes emerging after ASCT. Higher response rates to primary treatment can be achieved with MPM. |
| Databáze: | OpenAIRE |
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