Ceftazidime의 임상적 연구 : 과립구 감소환자에서의 감염증에서 Piperacillin-Tobramycin 병합요법과의 비교연구 Ceftazidime or Piperacillin plus Tobramycin and the Possible Modifications Required for a Successful Outcome = Management of the Febrile Granulocytopenic Patients

다국어 초록 (Multilingual Abstract)

In a randomized, prospective study, ceftazidime monotherapy was compared with a combination of piperacillin and tobramycin for the treatment of infection in febrile granulocyto penic cancer patients. The subjects consisted of 40 patients with acute leukemia or solid tumor who developed fever and other signs of infections after induction chemotherapy or bone marrow transplantation. 21 patients were randomized to the piperacillin plus tobramycin combination, while 19 patients were allocated to ceftazidime monotherapy. Initial granulocyte count, duratation of granulocytopenia, infection days and granulocyte count on therapeutic responsewere all comparable in both treatment groups. On 72 hour assessment, success (with or with-out modification) rate according to NCI criteria was 100% in ceftazidime and 95% in combination group. Success according to EORTC criteria was 26% and 48% respectively. On posttreatment assessment, success rate according to MCI criteria was 91% in ceftazidime group and 70% in combination group, while one according to EORTC was 33% and 40% respectively. There was no statistical significance between the two success rates.
The superinfection was more commonly seen in the combination group, esp. by resistant E. coli, even though the difference was not significant.