23 research outputs found
Piperacillin-tazobactam plus amikacin versus ceftazidime plus amikacin as empiric therapy for fever in granulocytopenic patients with cancer. The International Antimicrobial Therapy Cooperative Group of the European Organization for Research and Treatment of Cancer
High-risk febrile neutropenia in Auckland 2003-2004: the influence of the microbiology laboratory on patient treatment and the use of pathogen-specific therapy
Comparison of two antibiotic regimens (piperacillin plus amikacin versus ceftazidime plus amikacin) as empiric therapy for febrile neutropenic patients with cancer
Spectrum and treatment of bacterial infections in cancer patients with granulocytopenia
Bacterial infections remain a frequent cause of morbidity and mortality in cancer patients with granulocytopenia. In recent years the proportion of patients with gram-positive infections, caused mainly by coagulase-negative staphylococci and viridans streptococci, has increased markedly in many institutions. The precise reasons for this recent change in the epidemiology of infection in cancer patients are as yet not fully ascertained. Although less prevalent, gram-negative infections are still the major threat, since they are associated with higher mortality. What constitutes the optimal empirical antibiotic therapy remains a controversial issue. One should however recognize that the results of one particular study may not be relevant to other institutions where the predominant pathogens and the pattern of antibiotic resistance may be different. In addition, the results of studies using various antibiotic regimens should be compared with caution. However, with these limitations in mind, the results of the most recently published studies support the following recommendations: in patients with nonmicrobiologically documented infections, monotherapy with a third-generation cephalosporin or a carbapenem is a safe alternative to combination therapy. For gram-negative bacteremia, combined therapy with an extended-spectrum beta-lactam antibiotic and an aminoglycoside appears preferable. For gram-positive infections, a specific anti-gram-positive antibiotic is not needed in every patient and can safely be added upon identification of the pathogen in those patients not responding to empirical therapy