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| Content Provider | Springer Nature Link |
|---|---|
| Author | Gómez, L. Estrada, C. Gómez, I. Márquez, M. Estany, C. Martí, J. M. Bastús, R. Cirera, L. Quintana, S. Garau, J. |
| Copyright Year | 2010 |
| Abstract | Patients with fever and granulocytopenia are at risk of developing severe infection. We performed a prospective, randomized trial to evaluate the efficacy of low-dose cefepime plus amikacin (C-A) compared to low-dose piperacillin/tazobactam plus amikacin (PT-A). Patients received cefepime (2 g/12 h) plus amikacin (15 mg/kg/day) or piperacillin/tazobactam (4 g/500 mg/8 h) plus amikacin. A total of 317 episodes of febrile granulocytopenia in 190 patients were studied (152 in the C-A group, 165 in the PT-A group). A microbiologically documented infection was present in 53 (35%) episodes in the C-A group and 41 (25%) episodes in the PT-A group (p = ns); a clinically documented infection was observed in 39 (26%) and 47 (28%) episodes, respectively. Toxicity was observed in 6 (4%) episodes in the C-A group and in 5 (3%) episodes in the PT-A group. The antibiotic success rate (no change or addition of antibiotics) was recorded in 89 (59%) and 105 (64%) cases, respectively (p = ns). Mortality related to infection was similar in each arm (3.9% vs. 3.6%). Combination therapy of low-dose β-lactam with an aminoglycoside achieves very good response rates and low rates of toxicity. It might be an attractive option in an environment of increasing resistance among gram-negative bacteria. |
| Starting Page | 417 |
| Ending Page | 427 |
| Page Count | 11 |
| File Format | |
| ISSN | 09349723 |
| Journal | European Journal of Clinical Microbiology & Infectious Diseases |
| Volume Number | 29 |
| Issue Number | 4 |
| e-ISSN | 14354373 |
| Language | English |
| Publisher | Springer-Verlag |
| Publisher Date | 2010-02-27 |
| Publisher Place | Berlin, Heidelberg |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Medical Microbiology Internal Medicine |
| Content Type | Text |
| Resource Type | Article |
| Subject | Infectious Diseases Microbiology (medical) |
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