[First-line treatment of febrile episodes in leukemia in adults. Randomized, multicenter study of ceftazidime in single antibiotic therapy versus a cefotaxime-amikacin combination].
A prospective study was conducted in 10 haematology departments of university hospitals on 174 leukaemic patients with prolonged bone marrow aplasia and presenting with a febrile episode. The patients were allocated at random to either ceftazidime or the cefotaxime-amikacin combination. The two treatment group were similar as regards age, sex, underlying blood disease, duration of neutropenia, presence of a venous catheter, type of digestive tract contamination, clinical and bacteriological findings. Results were assessed mainly on the course of the fever at 48 hours and on the clinical and bacteriological changes observed until the patients came out of aplasia. Documented infections were specifically analyzed. There was no significant difference in terms of success or failure between the two treatment groups. Ceftazidime administered as monotherapy proved as effective as the cefotaxime-amikacin combination in the empirical first-line treatment of febrile episodes in leukaemic patients with neutropenia.
Piguet
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H
Service d'Hématologie, Centre Henri Becquerel, Rouen.
Pappo
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D000328:Adult; D000583:Amikacin / Q000009:adverse effects / Q000627:therapeutic use*; D002439:Cefotaxime / Q000009:adverse effects / Q000627:therapeutic use*; D002442:Ceftazidime / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005334:Fever / Q000188:drug therapy*; D006801:Humans; D007938:Leukemia / Q000150:complications*; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D011897:Random Allocation
D000583:Amikacin; D002442:Ceftazidime; D002439:Cefotaxime
Traitement de première intention des épisodes fébriles des leucémies de l'adulte. Etude randomisée, multicentrique de la ceftazidime en monoantibiothérapie versus l'association céfotaxime-amikacine.