Severe gram-negative infections in neutropenic children cured by imipenem/cilastatin in combination with an aminoglycoside.
Nine severe Gram-negative septicaemias in neutropenic (less than 500 neutrophils/mm3) children with neoplastic diseases were treated with imipenem/cilastatin (75 mg/kg/day) in combination with an aminoglycoside. The bacterial strains (Pseudomonas aeruginosa 7, P. putida 1, Enterobacter cloacae 1) were resistant to penicillins and cephalosporins, or were isolated during treatment with a broad-spectrum penicillin to which the bacterial strain was sensitive in vitro. The mean duration of neutropenia was 18.5 (3-51) days and duration of treatment 20 (8-51) days. Pyrexia was controlled in 2.8 (1-10) days and eradication of the pathogen from blood in one day. No clinical and biological adverse reaction was observed. These results show imipenem/cilastatin to be an effective treatment of infections in severely immunocompromised patients.
Baruchel
A
A
Hartmann
O
O
Andremont
A
A
Tancrède
C
C
D000293:Adolescent; D000328:Adult; D000380:Agranulocytosis / Q000150:complications*; D000617:Aminoglycosides / Q000009:adverse effects / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D015377:Cilastatin; D003521:Cyclopropanes / Q000009:adverse effects / Q000627:therapeutic use*; D004150:Dipeptidases / Q000037:antagonists & inhibitors; D004359:Drug Therapy, Combination; D004755:Enterobacteriaceae / Q000187:drug effects; D005260:Female; D006090:Gram-Negative Bacteria; D006801:Humans; D015378:Imipenem; D007422:Intestines / Q000382:microbiology; D008297:Male; D009369:Neoplasms / Q000150:complications; D009503:Neutropenia / Q000150:complications*; D013845:Thienamycins / Q000009:adverse effects / Q000627:therapeutic use*
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D003521:Cyclopropanes; D013845:Thienamycins; D015377:Cilastatin; D015378:Imipenem; D004150:Dipeptidases