title: Effect of recombinant human granulocyte colony-stimulating factor on combination therapy with aztreonam and clindamycin for infections in neutropenic patients with hematologic diseases.
abstract: The present multicenter study was performed to evaluate the effect of recombinant human granulocyte-colony stimulating factor (rhG-CSF) on combination therapy using aztreonam (AZT) and clindamycin (CLDM) to treat severe infection in neutropenic patients with hematologic diseases. Forty-three neutropenic patients with infections (rhG-CSF group) were treated with AZT (2 g) and CLDM (600 mg) 2-3 times daily as well as rhG-CSF (Lenograstim or Filgrastim: 2-5 mu/kg/day). The clinical efficacy of this regimen was compared to that obtained in 44 febrile neutropenic patients, with hematologic diseases, who received only AZT and CLDM in a previous study (historical control group). The overall efficacy rate was 69.8% (30/43) in the rhG-CSF group and 65.9% (29/44) in the historical control group. Although the neutrophil count was significantly increased and C-reactive protein tended to be lower in the rhG-CSF group, the daily maximum body temperature profiles of the 2 groups were nearly the same. These results suggest that rhG-CSF is of little benefit in the treatment of single infectious episodes in neutropenic patients, and that appropriate antibiotic therapy is more important.
authors.affiliation: First Department of Internal Medicine, Tokyo Medical College.
authors.forename: K
authors.initials: K
authors.lastname: Toyama
authors.forename: M
authors.initials: M
authors.lastname: Yaguchi
authors.forename: H
authors.initials: H
authors.lastname: Mizoguchi
authors.forename: M
authors.initials: M
authors.lastname: Masuda
authors.forename: A
authors.initials: A
authors.lastname: Urabe
authors.forename: Y
authors.initials: Y
authors.lastname: Ikeda
authors.forename: I
authors.initials: I
authors.lastname: Aoki
authors.forename: T
authors.initials: T
authors.lastname: Shinbo
authors.forename: A
authors.initials: A
authors.lastname: Togawa
authors.forename: K
authors.initials: K
authors.lastname: Hirashima
authors.forename: Y
authors.initials: Y
authors.lastname: Miura
authors.forename: S
authors.initials: S
authors.lastname: Hirose
authors.forename: N
authors.initials: N
authors.lastname: Tsuruoka
authors.forename: M
authors.initials: M
authors.lastname: Omine
authors.forename: M
authors.initials: M
authors.lastname: Kamakura
authors.forename: T
authors.initials: T
authors.lastname: Saito
authors.forename: S
authors.initials: S
authors.lastname: Arimori
authors.forename: N
authors.initials: N
authors.lastname: Aoki
authors.forename: Y
authors.initials: Y
authors.lastname: Kuraishi
authors.forename: H
authors.initials: H
authors.lastname: Hirai
authors.forename: S
authors.initials: S
authors.lastname: Asano
authors.forename: M
authors.initials: M
authors.lastname: Mori
authors.forename: T
authors.initials: T
authors.lastname: Shirai
authors.forename: Y
authors.initials: Y
authors.lastname: Muto
authors.forename: F
authors.initials: F
authors.lastname: Takaku
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001398:Aztreonam / Q000008:administration & dosage*; D002981:Clindamycin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006801:Humans; D007938:Leukemia / Q000150:complications*; D008223:Lymphoma / Q000150:complications*; D008875:Middle Aged; D008997:Monobactams / Q000008:administration & dosage*; D009503:Neutropenia / Q000150:complications*; D011014:Pneumonia / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000008:administration & dosage; D018805:Sepsis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D008997:Monobactams; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D002981:Clindamycin; D001398:Aztreonam