Evaluation of azlocillin-amikacin combination for empirical therapy of infection in febrile neutropenic patients.
We have evaluated the azlocillin-amikacin combination, given at a daily dose of 200 mg/kg and 15 mg/kg respectively, in the treatment of 62 consecutive febrile granulocytopenic patients (less than 500 PMN/microliters) affected by hematological disease. The effectiveness of the treatment was assessed in 60 patients, 44 (73%) of whom responded within 96 hours from the beginning. 36 of the responders showed microbiological and clinical infections, 2 had clinically documented pneumonia and 6 a possible infection. No improvement was obtained in 16 patients; 7 of whom suffered from clinical and microbiological infection, 2 from pulmonary mycosis, 4 from possible infection and 3 from doubtful infection. Seven of these patients subsequently responded to a proven antibiotic treatment, while only one of the remaining responded to a second-line empirical antibiotic schedule. These results suggest that the combination of azlocillin-amikacin was able to overcome about two-thirds of the infections, representing an effective remedy for the empiric treatment of febrile neutropenic patients.
D'Antonio
D
D
Facoltà di Medicina e Chirurgia, Università degli Studi G. D'Annunzio, Chieti, Italy.
di Girolamo
A
A
Iacone
A
A
Fioritoni
G
G
Angelini
A
A
Dragani
A
A
Betti
S
S
Dell'Isola
M
M
Piccolomini
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000150:complications*; D000583:Amikacin / Q000008:administration & dosage*; D001390:Azlocillin / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*
D000583:Amikacin; D001390:Azlocillin