Ceftazidime in combination with glycopeptide antibiotic is an effective first-line therapy for patients undergoing high-dose therapy with autologous peripheral blood stem cell support

• Verfasst von: Egerer, Gerlinde [VerfasserIn]
• Verfasst von: Goldschmidt, Hartmut [VerfasserIn]
• Verfasst von: Streich, Nikolaus [VerfasserIn]
• Verfasst von: Ehrhard, Ingrid [VerfasserIn]
• Verfasst von: Sonntag, Hans-Günther [VerfasserIn]
• Verfasst von: Haas, Rainer [VerfasserIn]
• Titel: Ceftazidime in combination with glycopeptide antibiotic is an effective first-line therapy for patients undergoing high-dose therapy with autologous peripheral blood stem cell support
• Verf.angabe: G. Egerer, H. Goldschmidt, N. Streich, I. Ehrhard, H.G. Sonntag & R. Haas
• Jahr: 1999
• Umfang: 7 S.
• Teil: volume:7
• Teil: year:1999
• Teil: number:5
• Teil: pages:336-342
• Teil: extent:7
• Fussnoten: Gesehen am 12.04.2021
• Titel Quelle: Enthalten in: Supportive care in cancer
• Ort Quelle: Berlin : Springer, 1993
• Jahr Quelle: 1999
• Band/Heft Quelle: 7(1999), 5, Seite 336-342
• ISSN Quelle: 1433-7339
• DOI: doi:10.1007/s005200050272
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1753625831

Abstract

It was the objective of this study to evaluate the efficacy and toxicity of an empirical antibiotic therapy consisting in ceftazidime and a glycopeptide antibiotic. All patients enrolled in the study had hematological malignancies and underwent high-dose therapy with peripheral blood stem cell (PBSC) support. In this retrospective study, 183 of 207 patients who had received a PBSC-supported high-dose therapy were evaluable. Any patients who had fever higher than 38.5°C received ceftazidime in combination with vancomycin (105 patients) or teicoplanin (69 patients). In 80 of 174 patients with fever (45%) the fever resolved within 72 h as a result of the treatment with ceftazidime and the glycopeptide antibiotic. In nonresponding patients, the changes included the replacement of ceftazidime by imipenem/cilastin (94 patients) and the addition of erythromycin (12 patients) or metronidazole (3 patients). Amphotericin B was administered in 29 patients. Following hematological reconstitution, the fever and clinical signs, including radiographic findings, resolved in 20 primarily nonresponding patients. In blood cultures, a significantly higher incidence of gram-positive than of gram-negative bacteria was observed (26 vs 7). The toxicity of the first-line antibiotic therapy was limited to allergic skin reactions in 12 patients. Ceftazidime in combination with a glycopeptide antibiotic provides an effective and safe first-line therapy for patients with neutropenic fever following PBSC-supported high-dose therapy.