Document Detail


Combination of amikacin and either ampicillin or cephalotin as initial treatment of febrile neutropenic patients.
MedLine Citation:
PMID:  6760676     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A prospective, randomized trial of two antibiotic combinations (amikacin plus either ampicillin or cephalotin) was performed on 39 consecutive episodes of fever in 30 patients with neutropenia and hematological malignancy. Infections were documented as the cause of fever in 37 episodes (95%): in 21 episodes (54%) bacteria or a virus (n = 1) were isolated, and in 16 (41% of all episodes) the infection was documented clinically but no pathogen was isolated. The most frequently isolated bacteria were Staph. aureus (38% of all strains), E. coli (13%), and Pseudomonas aeruginosa (13%). Bacteremia occurred in 18% of the febrile episodes. Improvement followed treatment with the combination amikacin plus ampicillin in 73% of 19 cases, and with amikacin plus cephalotin in 55% of 20 cases (p less than 0.05), giving a total improvement rate of 64%. Failure of therapy was seen in episodes caused by multiple bacteria or Pseudomonas infections. Mild signs of nephrotoxicity were noted in 13% during both regimens. Audiograms were normal in all but two patients who showed slight high-frequency hearing loss. A second infection occurred in 7 episodes (18%). Thus, the combination of amikacin plus ampicillin was as efficient (but less expensive) as amikacin plus cephalotin in the initial treatment of febrile episodes in neutropenic patients with hematological malignancies.
Authors:
J Palmblad; B Lönnqvist
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta medica Scandinavica     Volume:  212     ISSN:  0001-6101     ISO Abbreviation:  Acta Med Scand     Publication Date:  1982  
Date Detail:
Created Date:  1983-03-11     Completed Date:  1983-03-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370330     Medline TA:  Acta Med Scand     Country:  SWEDEN    
Other Details:
Languages:  eng     Pagination:  379-84     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Agranulocytosis / complications*
Amikacin / therapeutic use*
Ampicillin / therapeutic use*
Bacterial Infections / drug therapy*,  etiology
Cephalothin / therapeutic use*
Clinical Trials as Topic
Drug Combinations
Female
Fever / drug therapy
Hematologic Diseases / complications
Humans
Kanamycin / analogs & derivatives*
Male
Middle Aged
Neutropenia / complications*
Prospective Studies
Random Allocation
Chemical
Reg. No./Substance:
0/Drug Combinations; 153-61-7/Cephalothin; 37517-28-5/Amikacin; 59-01-8/Kanamycin; 69-53-4/Ampicillin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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