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β‐Lactam regimens for the febrile neutropenic patient
Author(s) -
Bodey Gerald P.,
Fainstein Victor,
Elting Linda S.,
Anaissie Elias,
Rolston Kenneth,
Khardori Nancy,
Kantarjian Hagop,
Plager Carl,
Murphy William K.,
Holmes Frankie,
Cabanillas Fernando
Publication year - 1990
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19900101)65:1<9::aid-cncr2820650105>3.0.co;2-c
Subject(s) - medicine , neutropenia , ticarcillin , regimen , febrile neutropenia , antibiotics , empiric therapy , vancomycin , ceftazidime , surgery , chemotherapy , clavulanic acid , staphylococcus aureus , genetics , alternative medicine , pathology , biology , bacteria , microbiology and biotechnology , pseudomonas aeruginosa , amoxicillin
A total of 535 evaluable febrile episodes in neutropenic patients were randomly assigned to treatment with ticarcillin‐clavulanate plus vancomycin (TV), ceftazidime plus vancomycin (CV), or all three antibiotics (TCV). The TCV regimen was significantly more effective than TV, considering all evaluable episodes, documented infections, gram‐negative infections, and infections in patients with persistent severe neutropenia (< 100 neutrophils/mm 3 ). The results with CV were intermediate between TV and TCV. The toxicities were similar with all three regimens and consisted primarily of skin rashes. The TCV regimen is effective for empiric therapy of fever in neutropenic patients and probably should be utilized in preference to CV or TV, although its superiority over CV in this study was inconclusive.