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과립구 감소증 환자의 감염에서 Imipenem/Cilastatin 단독요법과 Piperacillin과 Amikacin 병합요법의 비교
양영상,한치화,신완식,박종원,강문원,김춘추,김동집,정희영 대한화학요법학회 1990 대한화학요법학회지 Vol.8 No.2
We studied a prospective, randomized trial to assess the clinical efficacy of monotherapy with imipenem/cilastatin relative to piperacillin plus amikacin as empiric antibacterial therapy in the treatment of infections in ueuropenic patients. Among 32 evaluable cases of infections in neutropenic patients, 16 were treated with imipenem/cilastatin, and the other 16 were treated with piperacillin plus amikacin. Among etiologic agents, gram-positive bacteria were 66.7%, gram-negative bacteria 26.7%, and fungi 6.6%. Results of therapy according to initial granulocyte count showed no significant difference in cure or improvement rate between imipenem/cilastatin and piperacillinplus amicacin but imipenem/cilastatin was prior in the group of granulocyte counts 500-1000×10^(6)/L, piperacillin plus amikacin was prior in the group of granulocyte counts less than 500×10^(6)/L. The clinical response rates in total patients were 69% for imipenem/cilastatin therapy and 63% for piperacillinplus amikacin, which showed more excellent efficacy of imipenem/cilastatin therapy, but without statistical significance. There was no major difference of incidence of side effect between the two regimens. We conclude that monotherapy with imipenem/cilastatin will be a good alternative to the combination therapy with piperacillin plus amikacin for infections in neutropenic patients.