[Results of several different controlled studies with ceftazidime in the treatment of infections in immunosuppressed patients].
At our Division of Hematology eight clinical studies were performed using ceftazidime alone or in combination with other antibiotics. In the first randomised study ceftazidime (45 patients) proved to be statistically superior (p less than or equal to 0.05) to the combination of cefotaxime and gentamicin (45 patients). The poor results of the latter combination - 49% clinical responses compared with 71% for ceftazidime - have been confirmed by the EORTC study group of Klastersky (1). The second study aimed at 30 patients who failed to respond to cefotaxime and gentamicin. All bacteriologically documented infections were cured with ceftazidime. The clinical response rate was 73%. In the third randomised study we compared ceftazidime plus flucloxacillin in 49 patients in order to extend the spectrum to resistant staphylococci with a ceftazidime monotherapy (51 patients). The addition of flucloxacillin did not improve the results substantially. The overall clinical response rate was 81% with the combination and 85% with ceftazidime alone. In the fourth study on 23 patients with allogenic bone marrow transplantations, receiving cyclosporin A as prophylaxis against graft versus host disease, no nephrotoxic effect was observed. The fifth study comprised 20 patients over 65 years of age, in whom no toxicity different from younger patients was seen. In the sixth study with 51 patients per group we compared ceftazidime with the combination ceftazidime plus cephalothin. This study demonstrated an increased efficacy of the combination against Staphylococcus epidermidis and proved that two different cephalosporins, given simultaneously, are not antagonistic. Analysis of 34 Pseudomonas septicaemias in the seventh study with a clinical success rate of 94% demonstrated clearly the potency of ceftazidime against this particularly dangerous organism.(ABSTRACT TRUNCATED AT 250 WORDS)
de Pauw
B E
BE
Dept. of Internal Medicine, University Hospital St. Radboud, University of Nijmegen.
D000208:Acute Disease; D001419:Bacteria / Q000187:drug effects; D001424:Bacterial Infections / Q000188:drug therapy*; D016026:Bone Marrow Transplantation; D002442:Ceftazidime / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006801:Humans; D007262:Infusions, Intravenous; D007938:Leukemia / Q000150:complications; D009894:Opportunistic Infections / Q000188:drug therapy*; D011552:Pseudomonas Infections / Q000188:drug therapy; D011897:Random Allocation; D018805:Sepsis / Q000188:drug therapy; D013203:Staphylococcal Infections / Q000188:drug therapy
D002442:Ceftazidime
Ergebnisse aus mehreren verschiedenen kontrollierten Studien mit Ceftazidim in der Behandlung von Infektionen bei immunsupprimierten Patienten.