title: Empirical antibiotic therapy in febrile neutropenic patients with single-daily dose amikacin plus ceftriaxone.
abstract: Hematologic malignancies and cancer patients who become neutropenic as a result of disease or myelosuppressive cytotoxic therapy are at a high risk of developing life-threatening infections, and hence empirical antibiotic therapy is administered promptly. We investigated once daily regimen of amikacin, for dose-dependent bactericidal activity and post-antibiotic effects, plus ceftriaxone, with a long-half life to maximise time-dependent bactericidal activity. Microbiologically proven septicemia were 11 out of 49 febrile episodes (22.5%) and 10 (91%) of these were due to gram-negative bacilli, mostly Enterobacteriaceae. The overall success of the regimen was 63.3 per cent of patients, with no significant toxicity. In conclusion, our findings suggest that once-daily administration of amikacin plus ceftriaxone in the initial treatment of febrile episodes in neutropenic patients produces satisfactory results and more cost-effective compared with other antibiotic regimens requiring 3-4 doses a day.
authors.affiliation: Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Suwangool
authors.forename: N
authors.initials: N
authors.lastname: Aswapokee
authors.forename: B
authors.initials: B
authors.lastname: Sathapatayavongs
authors.forename: S
authors.initials: S
authors.lastname: Leelasuphasri
authors.forename: N
authors.initials: N
authors.lastname: Siritanaratkul
authors.forename: S
authors.initials: S
authors.lastname: Chuncharunee
authors.forename: P
authors.initials: P
authors.lastname: Chayakul
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000583:Amikacin / Q000008:administration & dosage* / Q000627:therapeutic use; D002443:Ceftriaxone / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D005335:Fever of Unknown Origin / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications* / Q000188:drug therapy; D018805:Sepsis / Q000150:complications / Q000188:drug therapy*
chemical_list: D002443:Ceftriaxone; D000583:Amikacin