Medical Oncology and Tumor Pharmacotherapy

, Volume 6, Issue 4, pp 291–296 | Cite as

Combination of pipemidic acid, colistin sodium methanesulfonate and nystatin may be less effective than nystatin alone for prevention of infection during chemotherapy-induced granulocytopenia in acute leukemia

  • Kazumi Sampi
  • Masaharu Sakurai
  • Ryoji Kumai
  • Nobuo Maseki
  • Yasuhiko Kaneko
  • Masao Hattori
Original Articles


Pipemidic acid (PPA) and colistin sodium methanesulfonate (CLM) may selectively suppress aerobic gramnegative bacilli. Twenty-nine patients with acute leukemia were randomized after each course of consolidation chemotherapy to receive a single agent of nystatin (NYS) (34 courses) versus a combination of NYS, PPA and CLM (36 courses). The duration of fever over 39°C was longer with the three drug combination (4.6 ± 5.1 days) than with NYS alone (1.8 ± 1.8 days) (P < 0.01). Four cases of pneumonia occurred and four patients inclucling one having pneumonia died of infection with the three drug combination, while no pneumonia or death occurred with NYS alone (P = 0.06 andP = 0.06, respectively). The combination of NYS, PPA and CLM may be less effective than NYS alone for the prevention of infection in acute leukemia patients with chemotherapy-associated granulocytopenia.

Key words

Acute leukemia Prevention of infection Gut decontamination Pipemidic acid Colistin sodium methanesulfonate Nystatin 

Abbreviations used in this paper


pipemidic acid


colistin sodium methanesulfonate


nystatin ara-C, cytarabine


high dose ara-C








acute nonlymphocytic leukemia


acute lymphocytic leukemia


gentamicin, vancomycin and nystatin


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Copyright information

© Humana Press Inc. 1989

Authors and Affiliations

  • Kazumi Sampi
    • 1
  • Masaharu Sakurai
    • 2
  • Ryoji Kumai
    • 1
  • Nobuo Maseki
    • 1
  • Yasuhiko Kaneko
    • 3
  • Masao Hattori
    • 1
  1. 1.HematoIogy ClinicSaitama Cancer Center HospitalSaitamaJapan
  2. 2.Department of Cancer ChemotherapySaitama Cancer Center HospitalSaitamaJapan
  3. 3.Department of Laboratory MedicineSaitama Cancer Center HospitalSaitamaJapan

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