title: Aztreonam plus vancomycin versus gentamicin plus piperacillin as empirical therapy for the treatment of fever in neutropenic patients: a randomised controlled study.
abstract: The efficacy of aztreonam in combination with vancomycin was compared with that of gentamicin plus piperacillin as empirical antibiotic treatment for fever in 61 neutropenic patients. Aztreonam plus vancomycin was as effective, but no more effective, than gentamicin plus piperacillin. Aztreonam showed excellent clinical and in vitro efficacy against Gram-negative pathogens. Failure to respond to aztreonam plus vancomycin was, in most cases, due to presumed or documented fungal infection; by contrast, failure to respond to gentamicin plus piperacillin was frequently to be due to resistant or superadded infection with Gram-positive bacteria.
authors.affiliation: Department of Haematology, Royal London Hospital, London, United Kingdom.
authors.forename: S M
authors.initials: SM
authors.lastname: Kelsey
authors.forename: E
authors.initials: E
authors.lastname: Shaw
authors.forename: A C
authors.initials: AC
authors.lastname: Newland
mesh_terms: D000328:Adult; D001398:Aztreonam / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D005839:Gentamicins / Q000627:therapeutic use*; D006090:Gram-Negative Bacteria; D016905:Gram-Negative Bacterial Infections / Q000097:blood / Q000188:drug therapy; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications / Q000188:drug therapy*; D010878:Piperacillin / Q000627:therapeutic use*; D013203:Staphylococcal Infections / Q000188:drug therapy; D013212:Staphylococcus epidermidis; D014640:Vancomycin / Q000627:therapeutic use*
chemical_list: D005839:Gentamicins; D014640:Vancomycin; D001398:Aztreonam; D010878:Piperacillin