American Journal of Clinical Oncology · 1994 · 20 citations · 1 references
PharmacyPharmacologyPharmacotherapyAntimicrobial PharmacologyAntimicrobial PharmacotherapyChemotherapyAdverse Effects Of ChemotherapyDe-escalation Of Antimicrobial TherapyEmpiric Antimicrobial TherapyEmpiric Therapy SelectionFebrile Neutropenia ManagementDuration Of Antibiotic TreatmentEmpiric Therapy EvaluationEmpirical Antimicrobial TreatmentFebrile Neutropenia Empiric TherapyFebrile Neutropenia TreatmentNeutropenic Fever ManagementNeutropenic Infections
To evaluate the effect of adding amikacin (AMK) to imipenem-cilastatin (IPM/CS), we conducted a randomized controlled trial in patients who experienced neutropenia (< 1,000/mm3) and fever (> 38 degrees C) induced by cancer chemotherapy. There were 70 patients who entered the trial; 34 and 36 patients received IPM/CS plus AMK (arm A) and IPM/CS (arm B), respectively. There was no significant difference in patient characteristics between the two groups. Among 67 evaluable patients, 29 of 32 (91%) and 25 of 35 (71%) responded to the antibiotics therapy in arm A and B, respectively, with EORTC criteria (p < .047). Median days of antibiotics administration and of febrile episode over 38 degrees C were not statistically significantly different between arm A and B. There was no patient with severe side effects, such as seizure, and 17 patients (30%) experienced emesis in both groups. These data suggest IPM/CS plus AMK is therapeutically superior to IPM/CS alone in patients with neutropenic fever induced by cancer chemotherapy.
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