[Combination therapy with aztreonam and clindamycin on severe infections accompanying neutropenic patients with hematological disorders].
We studied effectiveness and safety of combination therapy of aztreonam (AZT) (2-6 g/day) and clindamycin (CLDM) (1,200-2,400 mg/day) on severe infections in neutropenic patients with hematological diseases. We administered AZT and CLDM to 250 consecutive patients and analyzed the results of a total of 212 cases for evaluation except 38 cases of exclusions and dropouts. Hematological malignancies constituted the dominating underlying diseases which represented 90.6% of all underlying diseases. The overall clinical efficacy of the combination therapy with AZT and CLDM was 65.6% and the following results were obtained for different categories: sepsis, 64.7%; suspected sepsis, 66.4%; and pneumonia 54.5%. Even severe patients with less than 100/microliters of neutrophil counts showed good responses with an efficacy rate at 57.4%. Side effects were observed in only 7 cases (2.8%). We concluded that the combination therapy with AZT and CLDM would be useful as empiric therapy against various infections in febrile neutropenic patients with hematological diseases.
Urabe
A
A
Third Department of Internal Medicine, Faculty of Medicine, University of Tokyo.
Takaku
F
F
Mizoguchi
H
H
Nomura
T
T
Aoki
N
N
Yamaguchi
H
H
Mutoh
Y
Y
Miura
Y
Y
Toyama
K
K
Hirashima
K
K
D000328:Adult; D000368:Aged; D001398:Aztreonam / Q000008:administration & dosage* / Q000009:adverse effects; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology; D002981:Clindamycin / Q000008:administration & dosage* / Q000009:adverse effects; D004341:Drug Evaluation; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D005260:Female; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*
D002981:Clindamycin; D001398:Aztreonam