A COMPARATIVE-STUDY OF INTRAVENOUS CIPROFLOXACIN AND BENZYLPENICILLIN VERSUS NETILMICIN AND PIPERACILLIN FOR THE EMPIRICAL-TREATMENT OF FEVER IN NEUTROPENIC PATIENTS

被引:22
作者
KELSEY, SM [1 ]
WOOD, ME [1 ]
SHAW, E [1 ]
JENKINS, GC [1 ]
NEWLAND, AC [1 ]
机构
[1] LONDON HOSP,DEPT MICROBIOL,LONDON E1 1BB,ENGLAND
关键词
D O I
10.1093/jac/25.1.149
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
We examined the efficacy of ciprofloxacin as an empirical treatment for fever in 97 neutropenic patients in a randomized study of ciprofloxacin and benzylpenicillin versus netilmicin and piperacillin. Benzylpenicillin was included because of evidence of in-vitro resistance to ciprofloxacin in some streptococci. Clinical response rate was similar in the two groups (46% resolution for ciprofloxacin/benzylpenicillin and 52% for netilmicin/piperacillin). Microbiological assessment revealed more pathogens eradicated by ciprofloxacin and benzylpenicillin (66%) and fewer persisting (3%) than in patients receiving netilmicin and piperaciiin (52% and 13% respectively). Staphylococcus epidermidis was the commonest pathogen, accounting for 38% of all isolates and 30% of all treatment failures. There were no treatment failures or superinfections due to streptococci. More therapy-related adverse reactions were seen in patients on netilmicin and piperacillin (28%) compared with those on ciprofloxacin and benzylpenicillin (10%). The combination of ciprofloxacin and benzylpenicillin is as effective as a standard regimen of netilmicin and piperacillin, with fewer adverse effects, and is highly attractive as empirical therapy for the febrile, neutropenic host. The inclusion of benzylpenicillin prevents streptococcal-associated treatment failure. © 1990 The British Society for Antimicrobial Chemotherapy.
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页码:149 / 157
页数:9
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