| Intravenous ciprofloxacin as empirical treatment of febrile neutropenic patients. | |
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MedLine Citation:
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PMID: 2589377 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A randomized study of treatment with ciprofloxacin combined with benzylpenicillin (CB) versus a standard regimen of netilmicin combined with piperacillin (NP) as first-line empiric therapy was conducted in febrile neutropenic patients. Ninety-six patients were evaluable for determination of efficacy: 50 patients received CB and 46 patients received NP. There was no significant difference between the two groups in terms of age or primary diagnosis. Overall clinical response rate at the end of therapy was 66 percent for CB and 65 percent for NP. Microbiologic assessment revealed more pathogens eradicated by CB (64 percent) and fewer persisting (4 percent) than in the NP group (52 percent eradicated, 13 percent persisting). Only 10 percent of patients in the CB group had treatment-related adverse reactions as opposed to 28 percent of the NP-treated patients; these were predominantly renal impairment and were likely to have been due to the aminoglycoside. Staphylococcus epidermidis was the most commonly isolated pathogen, accounting for 38 percent of all isolates and 30 percent of all patients in whom treatment failed. Although streptococci accounted for 18 percent of the isolated pathogens, no treatment failures or superinfections were due to these organisms. This indicates an advantage of combining ciprofloxacin with benzylpenicillin. We conclude that the CB regimen is as effective as the NP treatment and is associated with fewer side effects. |
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Authors:
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S M Kelsey; M E Wood; E Shaw; A C Newland |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of medicine Volume: 87 ISSN: 0002-9343 ISO Abbreviation: Am. J. Med. Publication Date: 1989 Nov |
Date Detail:
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Created Date: 1990-01-02 Completed Date: 1990-01-02 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 274S-277S Citation Subset: AIM; IM |
Affiliation:
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Department of Haematology, London Hospital, Whitechapel, United Kingdom. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Agranulocytosis Bacteria / isolation & purification Bacterial Infections / drug therapy* Ciprofloxacin / administration & dosage*, adverse effects Drug Therapy, Combination Fever / drug therapy* Humans Infusions, Intravenous Middle Aged Netilmicin / administration & dosage Neutropenia / complications* Penicillin G / administration & dosage Piperacillin / administration & dosage Random Allocation |
| Chemical | |
Reg. No./Substance:
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56391-56-1/Netilmicin; 61-33-6/Penicillin G; 61477-96-1/Piperacillin; 85721-33-1/Ciprofloxacin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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