Document Detail


Imipenem/cilastatin monotherapy as salvage treatment in febrile neutropenic patients.
MedLine Citation:
PMID:  8957719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Imipenem/cilastatin (I/C) monotherapy was used as salvage treatment in 55 neutropenic patients (58 fever episodes) after treatment failure on first-line antibiotic therapy. Successful antibiotic treatment was defined as eradication of all signs, symptoms and microbiologic evidence of infection on I/C monotherapy alone. Twenty-five out of the 58 episodes (43%) were classified as success, 6 episodes (10%) as initial response but the regimen had to be modified (amphotericin B was added) and 27 episodes (47%) as failures. In episodes with documented infections 9 out of 23 (39%) were classified as success. All patients survived during the first 72 hours after change to I/C therapy. One patient had to discontinue I/C due to a skin rash. In conclusion, the use of a treatment algorithm with I/C monotherapy as second-line treatment was safe and effective. Other antimicrobial agents, most often vancomycin and/or amphotericin B, had to be added in half of the patients.
Authors:
P Engervall; G Günther; P Ljungman; B Lönnqvist; R Hast; G Stiernstedt; M Kalin; S Ringertz; M Björkholm
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of chemotherapy (Florence, Italy)     Volume:  8     ISSN:  1120-009X     ISO Abbreviation:  J Chemother     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1997-04-02     Completed Date:  1997-04-02     Revised Date:  2009-08-04    
Medline Journal Info:
Nlm Unique ID:  8907348     Medline TA:  J Chemother     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  382-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cilastatin / adverse effects,  therapeutic use*
Drug Therapy, Combination / adverse effects,  therapeutic use*
Female
Fever / drug therapy*,  etiology
Humans
Imipenem / adverse effects,  therapeutic use*
Male
Middle Aged
Neutropenia / complications,  drug therapy*
Prospective Studies
Retreatment
Treatment Outcome
Chemical
Reg. No./Substance:
74431-23-5/Imipenem; 82009-34-5/Cilastatin

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


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