Aztreonam plus vancomycin (plus amikacin) vs. moxalactam plus ticarcillin for the empiric treatment of febrile episodes in neutropenic cancer patients.

Aztreonam plus vancomycin (AV), aztreonam plus vancomycin and amikacin (AVA), and moxalactam plus ticarcillin (MT) were compared in an ongoing, randomized, prospective trial of the treatment of febrile episodes in neutropenic patients with cancer. Vancomycin was combined with aztreonam to provide coverage against gram-positive bacteria. Patients with gram-negative bacterial infections who were given AV in effect received single-agent therapy with aztreonam. Overall, AVA was more effective than MT and somewhat more effective than AV in the treatment of 170 documented infections. AV and AVA were each more effective than MT in the treatment of 29 gram-positive infections (response rates of 90%, 80%, and 43%, respectively). The three regimens were equally effective in the treatment of 39 aerobic gram-negative infections (response rates of 88%, 100%, and 100% for AV, AVA, and MT, respectively). Thus far, the addition of amikacin to the AV regimen appears to offer no advantage in the treatment of documented gram-negative infections.

[1]  L. Elting,et al.  Pseudomonas bacteremia. Retrospective analysis of 410 episodes. , 1985, Archives of internal medicine.

[2]  M. Keating,et al.  Piperacillin plus vancomycin in the therapy of febrile episodes in cancer patients , 1984, Antimicrobial Agents and Chemotherapy.

[3]  L. Elting,et al.  Moxalactam plus ticarcillin or tobramycin for treatment of febrile episodes in neutropenic cancer patients. , 1984, Archives of internal medicine.

[4]  E. Estey,et al.  Infection prophylaxis in acute leukemia. Comparative effectiveness of sulfamethoxazole and trimethoprim, ketoconazole, and a combination of the two. , 1984, Archives of internal medicine.

[5]  J. Quinn,et al.  Outbreak of JK diphtheroid infections associated with environmental contamination , 1984, Journal of clinical microbiology.

[6]  J. Jorgensen,et al.  In vitro activity of aztreonam in combination with newer beta-lactams and amikacin against multiply resistant gram-negative bacilli , 1984, Antimicrobial Agents and Chemotherapy.

[7]  M. Marks,et al.  In vitro antimicrobial activity of aztreonam alone and in combination against bacterial isolates from pediatric patients , 1984, Antimicrobial Agents and Chemotherapy.

[8]  L. Elting,et al.  A randomized study of ceftazidime compared to ceftazidime and tobramycin for the treatment of infections in cancer patients. , 1983, The Journal of antimicrobial chemotherapy.

[9]  P. Wiernik,et al.  Staphylococcus epidermidis: an increasing cause of infection in patients with granulocytopenia. , 1982, Annals of internal medicine.

[10]  L. Young,et al.  Piperacillin plus amikacin therapy v carbenicillin plus amikacin therapy in febrile, granulocytopenic patients. , 1982, Archives of internal medicine.

[11]  R. Finley,et al.  Empiric antibiotic therapy for suspected infection in granulocytopenic cancer patients: a comparison between the combination of moxalactam plus amikacin and ticarcillin plus amikacin. , 1982, The American journal of medicine.

[12]  G. Bodey,et al.  Infectious complications in leukemic patients. , 1982, Seminars in hematology.

[13]  C. Linnemann,et al.  Bacteremia due to methicillin-resistant Staphylococcus aureus. , 1982, The Journal of infectious diseases.

[14]  K. Bush,et al.  Azthreonam (SQ 26,776), a synthetic monobactam specifically active against aerobic gram-negative bacteria , 1982, Antimicrobial Agents and Chemotherapy.

[15]  R. H. Parker,et al.  Bacteremia due to Staphylococcus aureus in patients with cancer: report on 45 cases in adults and review of the literature. , 1982, Reviews of infectious diseases.

[16]  G. Bodey,et al.  In vitro evaluation of Ro 13-9904 , 1980, Antimicrobial Agents and Chemotherapy.

[17]  G. Harding,et al.  A prospective controlled investigation of prophylactic trimethoprim/sulfamethoxazole in hospitalized granulocytopenic patients. , 1979, The American journal of medicine.

[18]  W. Hewitt,et al.  Antimicrobial synergism in the therapy of gram-negative rod bacteremia. , 1978, Chemotherapy.

[19]  R. Feld,et al.  Amikacin therapy of infections in neutropenic patients , 1975, The American journal of the medical sciences.

[20]  J. Klastersky,et al.  Clinical Significance of In Vitro Synergism Between Antibiotics in Gram-Negative Infections , 1972, Antimicrobial Agents and Chemotherapy.

[21]  G. Bodey,et al.  Infections in cancer patients. Results with gentamicin sulfate therapy , 1972, Cancer.