Teicoplanin Plus Ciprofloxacin Versus Gentamicin Plus Piperacillin in the Treatment of Febrile Neutropenic Patients

Overview

Journal Eur J Clin Microbiol Infect Dis

Publisher Springer

Specialties Infectious Diseases
Microbiology

Date 1992 Jun 1

PMID 1388120

Citations 5

Authors

S M Kelsey

B Weinhardt

P W Collins

A C Newland

Affiliations

Soon will be listed here.

Abstract

Teicoplanin plus ciprofloxacin was compared with gentamicin plus piperacillin for the empirical treatment of fever in 80 neutropenic patients. A favourable response was seen in 78% of patients receiving teicoplanin plus ciprofloxacin and in 49% receiving gentamicin plus piperacillin (p less than 0.05). When microbiologically documented episodes were analysed separately, the response to teicoplanin plus ciprofloxacin was favourable in 81% of patients whereas only 35% responded favourably to gentamicin plus piperacillin (p = 0.034). Gram-positive organisms accounted for 76% of bacterial isolates, Staphylococcus epidermidis being the most common pathogen. Ten of 12 (83%) Staphylococcus epidermidis infections resolved when treated with teicoplanin plus ciprofloxacin as compared with 2 of 8 (25%) treated with gentamicin plus piperacillin. Teicoplanin is at least as effective as gentamicin plus piperacillin in the empirical treatment of febrile neutropenic patients and may be more effective in situations where gram-positive organisms are prevalent. The high incidence of gram-positive infections in our unit justifies the use of an agent with specific activity against gram-positive organisms in the first-line antibiotic regimen.

Citing Articles

Monotherapy with intravenous followed by oral high-dose ciprofloxacin versus combination therapy with ceftazidime plus amikacin as initial empiric therapy for granulocytopenic patients with fever.

Giamarellou H, Bassaris H, Petrikkos G, Busch W, Voulgarelis M, Antoniadou A Antimicrob Agents Chemother. 2000; 44(12):3264-71.

PMID: 11083625 PMC: 90190. DOI: 10.1128/AAC.44.12.3264-3271.2000.

Management of febrile neutropenia in low risk cancer patients.

Oppenheim B, Anderson H Thorax. 2000; 55 Suppl 1:S63-9.

PMID: 10943642 PMC: 1765939. DOI: 10.1136/thorax.55.suppl_1.s63.

A survey of the use of teicoplanin in patients with haematological malignancies and solid tumours.

Davies J Infection. 1998; 26(6):389-95.

PMID: 9861566 DOI: 10.1007/BF02770842.

The use of quinolones as therapy in granulocytopenic cancer patients. Comparison with other antimicrobials.

Krcmery Jr V Drugs. 1995; 49 Suppl 2:139-43.

PMID: 8549284 DOI: 10.2165/00003495-199500492-00023.

Use of the quinolones in the prophylaxis and treatment of granulocytopenic immunocompromised cancer patients.

Van der Auwera P, Gerain J Drugs. 1993; 45 Suppl 3:81-90.

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