Penicillin or vancomycin plus ceftazidime in febrile neutropenic patients after stem cell transplantation.
The response of gram-positive cocci to third generation cephalosporin therapy in febrile neutropenic patients is not optimal. We evaluated the safety and efficacy of ceftazidime plus penicillin (C + P) and compared it to ceftazidime plus vancomycin (C + V) in febrile neutropenic patients. The study includes 64 patients admitted to the Department of Haematology. Thirty-six patients were treated with C + V and 28 patients with C + P. Control of infection was observed in 78% of the patients in the C + V group and in 57% of the patients in C + P group (p = 0.5). Infection was the cause of the death of 1 patient in each group. We conclude that the combination of C + P has the same activity as the combination of C + V in febrile neutropenic patients. The morbidity and mortality were identical in both groups but cost effectiveness was in favour of the C + P group.
Kargar Samani
K
K
Division of Haematology, Centre Hospitalier Régional de Tournai, Belgium.
Vandercam
B
B
Straetmans
N
N
Michaux
L
L
Ferrant
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology; D016026:Bone Marrow Transplantation; D002442:Ceftazidime / Q000008:administration & dosage / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D004338:Drug Combinations; D005260:Female; D005334:Fever / Q000188:drug therapy*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000188:drug therapy*; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D012449:Safety; D013203:Staphylococcal Infections / Q000188:drug therapy; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D004338:Drug Combinations; D010406:Penicillins; D014640:Vancomycin; D002442:Ceftazidime