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Using teicoplanin for empiric therapy of febrile neutropenic patients with haematological malignancies
Author(s) -
Menichetti F.,
Favero A. Del,
Bucaneve G.,
Aversa F.,
Fiorio M.
Publication year - 1990
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1990.tb07936.x
Subject(s) - teicoplanin , medicine , neutropenia , febrile neutropenia , amikacin , antibiotics , vancomycin , ceftazidime , empiric therapy , gastroenterology , chemotherapy , microbiology and biotechnology , biology , staphylococcus aureus , bacteria , pseudomonas aeruginosa , genetics
S ummary The cumulative experience with teicoplanin in treating febrile neutropenic patients included in three different comparative clinical trials conducted at a single institution during a 3‐year period, is presented. 1 52 febrile episodes in 129 neutropenic patients were treated with iv. teicoplanin (6 mg/kg/d) combined with amikacin (15 mg/kg/d) plus ceftazidime (90 mg/kg/d). The study population comprised 75 patients with acute leukaemia and 77 marrow recipients: 53(% (81/152) had a central venous catheter in place and 68%) (103/152) had severe neutropenia (< 100/mm 3 ) at the beginning of the febrile episode. The overall response rate of the evaluiable febrile episodes was excellent: 88% (107/122) improved. Bacteraemias due to Gram‐positive cocci accounted for 75% of the total (42/56) and pathogens in the blood isolates were mostly staphylo‐cocci (coagulase‐negative 14, coagulase‐positive 13) and streptococci (131. The response rate of Gram‐positive bacteraemias was good: 88% (37/42) improved and 75% (9/12) of Gram‐positive bacteraemias having teicoplanin as the only antibiotic with in vitro activity against the infective strains were cured. Death due to infection accounted for 7% of total febrile episodes (11/152). Side effects were documented in 14(%, of the episodes. In a setting of high prevalence of Grampositive infections caused by strains with a high rate of resistance to aminoglycoside and betalactam antibiotics, there may be an advantage in including teicoplanin in the initial empiric antibiotic regimen for febrile neutropenic cancer patients.