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Titolo:
A randomized prospective multicentre trial of cefpirome versus piperacillin-tazobactam in febrile neutropenia
Autore:
Bauduer, F; Cousin, T; Boulat, O; Rigal-Huguet, F; Molina, L; Fegueux, N; Jourdan, E; Boiron, JM; Reiffers, J;
Indirizzi:
CHI Cote Basque, Serv Malad Sang, Dept Hematol, F-64100 Bayonne, France CHI Cote Basque Bayonne France F-64100 Hematol, F-64100 Bayonne, France
Titolo Testata:
LEUKEMIA & LYMPHOMA
fascicolo: 3, volume: 42, anno: 2001,
pagine: 379 - 386
SICI:
1042-8194(200107)42:3<379:ARPMTO>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
CEFTAZIDIME PLUS AMIKACIN; CANCER-PATIENTS; EMPIRIC THERAPY; ECONOMIC-CONSIDERATIONS; FEVER; MONOTHERAPY; COMBINATION; MANAGEMENT; EPISODES; BACTEREMIA;
Keywords:
neutropenic fever; cefpirome; piperacillin-tazobactam; randomized trial;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Bauduer, F CHI Cote Basque, Serv Malad Sang, Dept Hematol, F-64100 Bayonne, France CHI Cote Basque Bayonne France F-64100 -64100 Bayonne, France
Citazione:
F. Bauduer et al., "A randomized prospective multicentre trial of cefpirome versus piperacillin-tazobactam in febrile neutropenia", LEUK LYMPH, 42(3), 2001, pp. 379-386

Abstract

Fever is frequently the only clinical sign of infection in patients with chemo-induced neutropenia. In this setting, empirical administration of broad spectrum antibiotics must be rapid. The aim of this work was to compare, for the first time, cefpirome (CPO) and piperacillin-tazobactam (PT) in a large randomized trial. Two hundred-eight febrile neutropenic episodes (FNE)(greater than or equal to 38,5 degreesC and ANC less than or equal to 0.5 giga/l) were treated by randomization, as first line therapy, using either CPO 2 g x 2/day (105 cases) or PT 4 g x 3/day (103 cases), alone (CPO:15/PT: 15), or plus aminoglycoside (165 cases, CPO: 82/PT: 83) or quinolone CPO:2/PT: 2). There were 131 men and 77 women aged between 17 and 83 years (median: 49) who received chemotherapy (n=160) or allogeneic (n=10) or autologous (n=38) stem cell transplantations. Underlying diseases were: acute leukemia (n=131), lymphoma (n=33), myeloma (n=16), solid tumor (n=8), myeloproliferative disorder (n=9), chronic lymphoid leukemia (n=5), aplastic anemia (n=3), myelodysplasia (n=3). Distribution of age, neutropenia duration (median: 17 days), underlying disease, and protocol therapy duration (median: 11 days) was comparable in both arms. A microbiologically documented infection (MDI) was evidenced in 57 cases (27%). Bacteria were isolated from bloodcultures in 54 cases (Gram positive: 32 cases). Their in vitro susceptibility rates to CPO and PT were not different. Two days after antibiotics initiation, clinical (fever disappearance) and microbiological (culture negativation) success rates (SR) were 62% for CPO versus 61% for PT and 50% versus55% respectively in case of MDI (p = 0.89). Two deaths and 77 failures were registered. At the end of protocol, SR (no antibiotic change/absence of superinfection) was 59% with CPO versus 50% with FI(p = 0.27) and 53% versus40% respectively in the 151 cases with neutropenia greater than or equal to 10 days (p = 0.17). The occurrence of side effects was similar in both arms. In our hands, the efficacy of CPO and PT was comparable for treating FNE.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/07/20 alle ore 14:48:24