Premium
A Comparative Trial of Moxalactam Plus Ticarcillin and Clavulanic Acid or Piperacillin as Empiric Antibiotic Therapy for Febrile Cancer Patients
Author(s) -
D'Olimpio James T.,
Miller Michael,
Sheridan Carol A.,
Carlisle Penny,
Wollner David I.,
McKitrick John C.,
Wiernik Peter H.
Publication year - 1987
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1987.tb03086.x
Subject(s) - moxalactam , ticarcillin , piperacillin , medicine , empiric therapy , antibiotics , clavulanic acid , gastroenterology , amoxicillin , cephalosporin , microbiology and biotechnology , pseudomonas aeruginosa , genetics , alternative medicine , pathology , bacteria , biology
Resistance of bacteria to beta‐lactam antibiotics remains a difficult clinical problem that can be compounded in infected patients with serious underlying illness, especially those who are immunocompromised. In a prospective randomized safety and efficacy trial, febrile cancer patients received either ticarcillin disodium combined with the beta‐lacta‐mase inhibitor clavulante potassium (Timentin, Beecham Laboratories, Bristol, TN) plus moxalactam (T+M), or piperacillin plus moxalactam (P+M) as initial empiric antimicrobial therapy. Sixty‐six febrile episodes in 53 patients were studied. In the T+M group, 14 (78%) of 18 clinically evaluable infections in patients with profound granulocytopenia improved as did all 14 (100%) such infections in the P+M group. In the T+M group 17 of 21 (81%) similarly evaluable infections improved irrespective of granulocyte count, as did 14 (88%) of 16 of such infections in the P+M group. These results are not statistically significantly different. Serious side effects were infrequent and comparable with both regimens. There was one antibiotic related hemorrhage in the P+M group and a serious episode of nephrotoxicity in a patient who died without recovering renal function in the T+M group. These results suggest that the overall safety and efficacy of Timentin plus moxalactam, and piperacillin plus moxalactam are comparable and similar to previous empiric antibiotic trials.