Abstract
Cancer patients were randomized to receive an every 4 hour or every 8 hour schedule of cefoperazone plus aztreonam during 617 febrile episodes. The overall response rate for the 478 evaluable episodes was 76 % and there was no difference in response rate between the two schedules. The response rate was 79 % for cases of pneumonia and 63 % for cases of bacteremia. Only 50 % of the microbiologically documented infections caused by gram-positive organisms responded whereas 95 % of gram-negative infections, including all of those caused byPseudomonas aeruginosa, responded. Response rates were lower among patients whose neutrophil counts decreased during therapy than among those whose neutrophil counts increased (64 % vs. 85 %, p=0.008). Side-effects that were possibly or probably related to antibiotic therapy were observed during 11 % of the episodes. The most common side-effects were diarrhea and rashes including one case of Stevens-Johnson syndrome. Three patients developed a coagulopathy during therapy. Cefoperazone plus aztreonam proved to be an effective combination for treatment of gram-negative infections and fever of unknown origin in cancer patients and an every 8-hour schedule of administration was as effective as an every 4-hour schedule. Approximately half of the patients with gram-positive infections required additional antibiotics for successful therapy.
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Bodey, G., Reuben, A., Elting, L. et al. Comparison of two schedules of cefoperazone plus aztreonam in the treatment of neutropenic patients with fever. Eur. J. Clin. Microbiol. Infect. Dis. 10, 551–558 (1991). https://doi.org/10.1007/BF01967272
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DOI: https://doi.org/10.1007/BF01967272