A comparative efficacy and safety study of teicoplanin plus aztreonam versus gentamicin plus piperacillin in haematology oncology patients with clinically diagnosed septicaemia.
Infections due to Gram-positive bacteria, especially coagulase-negative staphylococci, have been increasing in immunocompromised patients during the last 5 years because of an increased use of Hickman catheters and oral gut decontamination with quinolones. Teicoplanin, a new glycopeptide antibiotic, has a long plasma half-life which allows once-a-day bolus administration, making it a 'user friendly' agent. A randomized comparative evaluation of teicoplanin plus aztreonam versus gentamicin plus piperacillin in leukaemic patients with a clinical diagnosis of septicaemia was undertaken. The objectives of this study were (1) to evaluate the efficacy and safety of teicoplanin and aztreonam in comparison to a 'standard antibiotic' regimen and (2) to assess the local and systemic tolerance of these drugs. Results of the study in more than 70 patients to date are presented, and the role of anti-Gram-positive antibiotics in the management of severe sepsis in immunocompromised patients is discussed.
Spencer
R C
RC
Department of Bacteriology, Royal Hallamshire Hospital, Sheffield.
Taylor
A K
AK
Winfield
D A
DA
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001398:Aztreonam / Q000627:therapeutic use / Q000633:toxicity; D001419:Bacteria / Q000302:isolation & purification; D004359:Drug Therapy, Combination; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006020:Glycopeptides / Q000627:therapeutic use / Q000633:toxicity; D006801:Humans; D007938:Leukemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D010878:Piperacillin / Q000627:therapeutic use; D011446:Prospective Studies; D018805:Sepsis / Q000188:drug therapy* / Q000382:microbiology; D017334:Teicoplanin
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D006020:Glycopeptides; D017334:Teicoplanin; D001398:Aztreonam; D010878:Piperacillin