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발열성 호중구 감소증 환자에서 Aztreonam, Vancomycin의 병합 치료에 대한 고찰
황정실,장선호,원종호,우준희,홍대식,박희숙,염윤기 대한화학요법학회 1991 대한화학요법학회지 Vol.9 No.1
The need for. prompt antibiotic therapy in the management of febrile neurropenic patients with malignancy is well established. Aztreonam ia new monobactam antibiotic with potent and specific activity against aerobic, Gram-negative becteria. It is active against pseudomonas aeruginosa, as well as Enterobacteriaceae. Vancomcin has exellent spectrum of activity against gram-positive organsisms, and the lack of significant resistance, have made it the drug of choice for treatment of many serious gram-positive infections. We evaluated the efficacy of combined therapy with aztreonam plus vancomycin in febrile neutropenic patients. 20 episodes of pyrexia in I6 immunocompromised adult atients(8 male, 8 female) with leukemia(All4, AML12) were managed with aztreonam and vancomycin for treatment of infections. The overall response rate was 70%(14 episodes). There were several side effects including sin rashes(3), increased aspartate aminotransferase(AST), alanine aminotransferase(ALT) with/without jaundice(5). Further study of possible adverse effects from vancomycin with aztreonam and potential development of antimicrobial resistance will be desired.
국내 3차병원에서 경험한 건강한 말초혈액 조혈모세포이식 기증자에서의 혈소판감소증
이수정,채승완,황정실,유승효,한재호,이호원,제갈동욱,김용구 대한수혈학회 2023 大韓輸血學會誌 Vol.34 No.2
In healthy peripheral blood stem cell (PBSC) donors, rare cases of transient thrombocytopenia have been reported due to the administration of granulocyte colony-stimulating factor (G-CSF) or the apheresis itself. Meanwhile, differentiating pseudothrombocytopenia induced by anticoagulants is crucial, as it can result in false low platelet counts. This study aimed to investigate the causes of thrombocytopenia in healthy PBSC donors. We investigated PBSC donors who experienced thrombocytopenia during transplantation at St. Mary’s Hospital, Seoul. Three donors were identified and donor workup studies were within the normal limits. After G-CSF administration prior to transplantation, the donors experienced a significant reduction in platelet counts. Apheresis resulted in lower levels, yet platelet counts returned to normal levels approximately two weeks later. In donor 3, thrombocytopenia was seen during the donor workup and ethylenediaminetetraacetic acid (EDTA)-induced pseudothrombocytopenia was identified after the supplementation of amikacin. For donor 3, we investigated whether his recipient’s sample showed EDTA-induced pseudothrombocytopenia through a review of any platelet clumping in the apheresis product and the presence of immunoglobulin M (IgM) or IgG antiplatelet antibodies in the recipient’s peripheral blood. In conclusion, the risk of severe thrombocytopenia with G-CSF administration in PBSC donors should be considered and accurate differentiation of pseudothrombocytopenia is imperative. (Korean J Blood Transfus 2023;34:108-117)