title: [Clinical evaluation of aztreonam for infections accompanying febrile neutropenic children with hematologic disorders and solid tumors. A cooperative study].
abstract: One hundred four children with infection accompanying hematologic disorders and solid tumors were treated with aztreonam (AZT) (120-150 mg/kg), either alone or in combination with one of the following drugs; cefmetazole (CMZ) (120-150 mg/kg), piperacillin (PIPC) (120-150 mg/kg), or amikacin (AMK) (5-10 mg/kg). The overall efficacy rate was 69.2%. Efficacy rates by regimen were as follows: AZT alone was 63.2%, AZT plus CMZ was 73.6%, AZT plus PIPC was 74.1% and AZT plus AMK was 20.0%. Efficacy rates in different types of infections were 53.2% for sepsis and suspected sepsis, 78.9% for pneumonia and respiratory tract infection, 93.1% for fever of undetermined origin and 55.6% for other infections. The efficacy rate was 71.3% in 94 patients in whom causative organisms were not identified and 50.0% in 10 patients in whom causative organisms were identified. Most of infections in which causative organisms were identified were caused by Gram-negative pathogens. The response rate among infections caused by Gram-negative bacilli was 50.0%. A combination of AZT and CMZ or PIPC was effective in 3 (100.0%) out of 3 patients in whom Escherichia coli was the causative organism. Efficacies classified according to different neutrophil counts were 59.3% for less than or equal to 100/microliters, 78.6% for 101-500/microliters and 82.4% for greater than or equal to 501/microliters. No significant adverse reactions were observed. These results indicated that combination of AZT and 2nd generation cephalosporins or penicillins were well tolerated and effective for infections complicated with accompanying hematologic disorders and solid tumors.
authors.affiliation: Department of Pediatrics, School of Medicine, Jikei University.
authors.forename: T
authors.initials: T
authors.lastname: Hirotsu
authors.forename: J
authors.initials: J
authors.lastname: Akatsuka
authors.forename: Y
authors.initials: Y
authors.lastname: Hoshi
authors.forename: H
authors.initials: H
authors.lastname: Uchiyama
authors.forename: K
authors.initials: K
authors.lastname: Fujisawa
authors.forename: N
authors.initials: N
authors.lastname: Kobayashi
authors.forename: N
authors.initials: N
authors.lastname: Ishidoya
authors.forename: M
authors.initials: M
authors.lastname: Ohira
authors.forename: J
authors.initials: J
authors.lastname: Takayama
authors.forename: Y
authors.initials: Y
authors.lastname: Ishida
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001398:Aztreonam / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D015311:Cefmetazole / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005260:Female; D005334:Fever / Q000150:complications; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000150:complications*
chemical_list: D015311:Cefmetazole; D001398:Aztreonam