[Effect of a combination treatment using imipenem/cilastatin sodium with G-CSF on infections in neutropenic patients with hematological malignancies].
The clinical effectiveness of a combination treatment using imipenem/cilastatin sodium (IPM/CS) with G-CSF was studied in neutropenic patients (< 500/mm3) with hematological malignancies and secondary infections. Thirty seven patients were entered in the trial, and 30 patients were eligible. This combination was effective in 20 patients, thus the overall efficacy rate was 66.7 percent. The combination was effective in all 6 cases with septicemia, in 10 case out of 15 cases with fever after chemotherapy (efficacy rate; 66.7%), in 3 out of 8 cases with respiratory infections including 7 cases with pneumonia (efficacy rate; 37.5%), and a case with laryngopharyngitis. According to the order of the administration, the efficacy rates were 60.0% in 5 cases in whom G-CSF treatment was started before IPM/CS, 66.7% in 21 cases given both G-CSF and IPM/CS simultaneously, and 75.0% in 4 cases in whom IPM/CS was started before G-CSF. The difference was statistically not significant on the efficacy rates in the three groups. The efficacy in 18 cases treated with monotherapy on antibiotic was 72.2% and that in 12 cases treated with IPM/CS in combination with other antibiotics was 58.3%, and the difference in the efficacy rates in these two groups was not statistically significant. According to the neutrophil counts before and after the treatment, high response rate (60.0%) was obtained in cases of severe neutropenia (less than 100/mm3). Bacteriological examinations showed that all of bacteria detected as pathogens (10 strains of Gram-positive bacteria and 6 strains of Gram-negative bacteria) were eradicated, though 3 strains were replaced by other pathogens.(ABSTRACT TRUNCATED AT 250 WORDS)
Sawada
H
H
1st Department of Internal Medicine, Faculty of Medicine, Kyoto University.
Sasada
M
M
Tajima
M
M
Yamamoto
K
K
Yasuda
N
N
Omori
S
S
Yumoto
Y
Y
Ishibashi
T
T
Okada
H
H
Suzuki
T
T
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology / Q000628:therapy*; D015377:Cilastatin / Q000008:administration & dosage; D000077728:Cilastatin, Imipenem Drug Combination; D004338:Drug Combinations; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*
D004338:Drug Combinations; D015377:Cilastatin; D016179:Granulocyte Colony-Stimulating Factor; D015378:Imipenem; D000077728:Cilastatin, Imipenem Drug Combination