title: A randomized clinical trial of ceftriaxone and teicoplanin versus ceftazidime and teicoplanin as antibiotic therapy in febrile neutropenic cancer patients and bone marrow transplant recipients.
abstract: A prospective, randomized clinical trial comparing combination therapy with ceftriaxone and teicoplanin versus ceftazidime and teicoplanin in the treatment of febrile episodes in neutropenic cancer patients and bone marrow transplant recipients was performed. One hundred and two patients were randomized, but two patients were considered unevaluable for efficacy, and three patients were withdrawn due to incorrect randomization. Of the remaining 97 patients, infection resolved without modification of therapy in 31/49 (63%) patients treated with ceftriaxone/teicoplanin versus 27/48 (56%) patients treated with ceftazidime/teicoplanin (P = 0.48). Of all 97 patients treated therapy was modified in 18/49 (36%) with ceftriaxone/teicoplanin and 21/48 (43%) with ceftazidime/teicoplanin. Nineteen patients treated with ceftriaxone/teicoplanin received netilmicin and 21 patients treated with ceftazidime/teicoplanin also received netilmicin according to the study design (escalation therapy). When netilmicin was added infection resolved in 78% of patients treated with ceftriaxone/teicoplanin versus 84% of those treated with ceftazidime/teicoplanin. It was concluded that combination therapy with ceftriaxone/teicoplanin is an alternative to combination therapy with ceftazidime/teicoplanin, and has the advantage of once daily administration.
authors.affiliation: Abt. Hämatologie und Onkologie, Medizinische Klinik, Albert-Ludwigs-Universität Freiburg, Germany.
authors.forename: A A
authors.initials: AA
authors.lastname: Fauser
authors.forename: E
authors.initials: E
authors.lastname: Lang
authors.forename: G
authors.initials: G
authors.lastname: Köchling
authors.forename: F D
authors.initials: FD
authors.lastname: Daschner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002442:Ceftazidime / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007239:Infections / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D009428:Netilmicin / Q000627:therapeutic use; D009503:Neutropenia / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D017334:Teicoplanin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D009428:Netilmicin; D017334:Teicoplanin; D002443:Ceftriaxone; D002442:Ceftazidime