Combination antibiotic/rhG-CSF therapy for bacterially infected granulocytopenic patients
- 6 Downloads
A clinical efficacy rate of 80.8% was obtained in 26 severely infected patients, neutropenic as a result of hematologic disease, following three-drug combination therapy with sulbactam/cefoperazone (SBT/CPZ), piperacillin (PIPC), and human recombinant granulocyte colony stimulating factor (rhG-CSF). By day 4 of treatment, patients average body temperature decreased from 38.6±0.8°C to 37.1±0.7°C and their neutrophil counts increased from 298±347/μL to 1757±2239/μL. When compared with 31 similar patients previously treated with SBT/CPZ and PIPC but without rhG-CSF, the efficacy rate in this study was somewhat higher but the difference was not statistically significant. However, there were statistically significant differences in body temperature on day 4 (37.1±0.7°C vs. 37.8±1.0°C) and in duration of fever in responding cases (3.1±1.7 vs. 4.8±2.4 days). These results suggest that addition of rhG-CSF provides a more rapid response and that the three-drug combination therapy can be selected as empiric therapy for infections in neutropenic patients.
Key wordsSulbactam/cefoperazone piperacillin rhG-CSF neutropenia pneumonia sepsis
Unable to display preview. Download preview PDF.
- 6.Valdivieso M. Bacterial infection in hematological disease. Clin Hematol 1976;5:229–248.Google Scholar
- 7.Minami S, Matsubara N, Muraoka T, Kurashige T, Mitsuhashi S. In vitro and in vivo antibacterial activity of cefoperazone (T-1551). Chemotherapy 1980;28(suppl 6):S1-S13.Google Scholar
- 9.Nishino T, Nakazawa T, Otsuki M, Tanino T. In vitro antibacterial activity sulbactam in combination with cefoperazone. Chemothersapy 1984;32(suppl 4):S51-S65.Google Scholar
- 10.Yokota T. Current status of beta-lactamase production by clinical isolates: studies in 432 hospital. Chemotherapy 1991;39:941–952.Google Scholar
- 11.Komoto A, Ogawa M, Sugi H, Nakamori Y. Combined effect of sulbactam/cefoperazone (SBT/CPZ) and piperacillin (PIPC) againstP. aeruginosa. The 28th Meeting of the JapanPseudomonas aeruginosa Society, 1994:179–184.Google Scholar
- 13.Urabe A, Takaku F, Mizoguchi H, Miura Y, Aoki N, Nomura T, et al. Clinical efficacy of imipenem/cilastatin sodium (IPM/CS) on various infections accompanying in hematological disorders. Antibiot Chemother 1990;6:1989–1998.Google Scholar
- 14.Urabe A, Takaku F, Mizoguchi H, Teramura M, Naruse T, Karasawa F, et al. Usefulness of ceftazidime (CAZ) for severe infection associated with hematological diseases. Antibiot Chemother 1989;5:1548–1554.Google Scholar
- 15.Toyama K, Yaguchi M, Wakasugi K, Ogawa T, Oshima T, Tsuruoka N, et al. Clinical evaluation of combination therapy with tobramycin and ceftazidime for severe infections associated with hematological disorders. Chemotherapy 1993;41:911–919.Google Scholar
- 18.Sheridan WP, Morstyn G, Wolf M, Dodds A, Lusk J, Maher D, et al. Granulocyte colony-stimulating factor and neutrophil recovery after high-dose chemotherapy and autologous bone-marrow transplantation. Lancet 1989;ii:891–895.Google Scholar
- 23.Funada H, Machi T, Ohtake S, Yoshida T, Matsuda T. Effect of recombinant human granulocyte colony-stimulating factor (G-CSF) in the treatment ofPseudomonas aeruginosa bacteremia complicating hematologic malignancy — a preliminary study. J Jpn Infect Dis 1992;66:76–80.Google Scholar
- 24.Yaguchi M, Toyama K, Ikeda Y, Aoki I, Watanabe K, Kawato M, et al. Effectiveness of concomitant therapy with amikacin, imipenem/cilastatin and human recombinant granulocyte colony stimulating factor for infected neutropenic patients with hematologic diseases. Jpn J Clin Hematol 1994;35:1079.Google Scholar