Efficacy of continuous infusion of ceftazidime for patients with neutropenic fever after high-dose chemotherapy and peripheral blood stem cell transplantation

Citation
G. Egerer et al., Efficacy of continuous infusion of ceftazidime for patients with neutropenic fever after high-dose chemotherapy and peripheral blood stem cell transplantation, INT J ANT A, 15(2), 2000, pp. 119-123
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Microbiology
Journal title
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
ISSN journal
0924-8579 → ACNP
Volume
15
Issue
2
Year of publication
2000
Pages
119 - 123
Database
ISI
SICI code
0924-8579(2000)15:2<119:EOCIOC>2.0.ZU;2-O
Abstract
Neutropenia is an important complication of high-dose chemotherapy (HDCT). Neutropenic patients presenting with fever are routinely hospitalized for t reatment with broad-spectrum antibiotics. Neutropenia up to 10 days is asso ciated with a low-risk profile, and antimicrobial therapy administered on a n outpatient basis might be an alternative to admission to hospital. This p rospective study evaluates the safety of a continuous infusion of ceftazidi me in neutropenic patients after HDCT and peripheral blood stem cell transp lantation (PBSCT). From September 1995 to October 1999, 81 patients receive d a 2 g intravenous bolus of ceftazidime, followed by a 4 g continuous infu sion per 24 h of ceftazidime using a portable infusion pump. If the fryer p ersisted for 72 h, a glycopeptide antibiotic was added. The median patients ' age was 44 years. Fifty-two of 81 patients (64%) responded to the monothe rapy with ceftazidime. After addition of a glycopeptide antibiotic, a furth er 17 patients (21%) became afebrile. The causes of fever were septicaemia in 11 patients, pneumonia in two and fever of unknown origin in 68 patients . Fifty-eight episodes (72%) were successfully managed by outpatient treatm ent alone. The reason for admission to hospital was the change to imipenem/ cilastin, which had to be administered three times per day (12 patients), s evere mucositis with parenteral nutrition (eight patients), or a Karnovsky index less than or equal to 60 (three patients). In six of these cases, out patient treatment was resumed after a brief period of in-patient care. In n o case was the treatment terminated because of failure of the pump. With da ily follow-up and close monitoring for development of complications, it is possible to discharge patients earlier after HDCT and PBSCT, thereby decrea sing costs. (C) 2000 Elsevier Science B.V. and International Society of Che motherapy. All rights reserved.