Imipenem-cilastatin for empirical therapy in neutropenic patients with fever: an open study in patients with hematologic malignancies.
In adult neutropenic patients with hematological malignancies, we explored imipenem-cilastatin as empirical antibiotic therapy in a dose of 500 mg four times daily. Changing to second-line treatment was only resorted to if clinical deterioration, new infections or recurrence of fever occurred. A clinically or microbiologically documented infection was apparent in 115 of 150 episodes studied (76.7%). Imipenem-cilastatin was successful in 70.7% of all episodes and in 67.8% of all proven infections. Modification was necessary and successful in 22.0% of all episodes. 11 patients died while still febrile, 6 of them by infection (4%) and 5 because of progressive disease (3.3%). Imipenem-cilastatin is safe initial therapy in neutropenic febrile patients.
Huijgens
P C
PC
Department of Hematology, Free University Hospital, Amsterdam, The Netherlands.
Ossenkoppele
G J
GJ
Weijers
T F
TF
van Loenen
A C
AC
Simoons-Smit
A M
AM
Wijermans
P W
PW
van Pampus
E C
EC
Langenhuijsen
M M
MM
D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D015377:Cilastatin / Q000009:adverse effects / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D005334:Fever / Q000209:etiology*; D006402:Hematologic Diseases / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D015378:Imipenem / Q000009:adverse effects / Q000627:therapeutic use*; D009503:Neutropenia / Q000209:etiology*; D013997:Time Factors
D000903:Antibiotics, Antineoplastic; D015377:Cilastatin; D015378:Imipenem