Clinical effects of aztreonam-combined therapy on infections in hematologic diseases. Comparison between clindamycin and piperacillin.:Comparison between clindamycin and piperacillin
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We evaluated the efficacy of combining aztreonam with clindamycin or piperacillin in severe infections complicating hematologic disorders. Ninety-seven infectious episodes were treated, : 57 underwent aztreonam/clindamycin therapy and 40 aztreonam/piperacillin therapy. In the aztreonam/clindamycin group, complicating infections consisted of suspected sepsis in 41, sepsis in 3, pneumonia in 11, urinary tract infection in one, and perianal abscess in one case, while the aztreonam/piperacillin group included suspected sepsis in 29, sepsis in 5, pneumonia in 4, tonsillitis in one, and subcutaneous abscess in one case. The clinical efficacy of aztreonam/clindamycin therapy was 52.6%(59% in suspected sepsis, 33% in sepsis, 46% in pneumonia), and in the aztreonam/piperacillin therapy group it was 60.0%(65% in suspected sepsis, 20% in sepsis, 75% in pneumonia). No statistically significant difference was found between the two groups. The number of organisms detected was too small to draw a conclusion, but neither of these two therapies were satisfactory for methicillin-resistant <I>Staphylococcus aureus</I> or <I>Pseudomonas aeruginosa</I> infections. During the neutropenic period (neutrophil count less than 500/μl), the efficacy of aztreonam/clindamycin and aztreonam/piperacillin therapy was 48%(n=27) and 41%(n=17), respectively. With neutrophil counts severely depressed under 100/μl, atreonam/clindamycin therapy showed better efficacy (32%) than aztreonam/piperacillin therapy (10%). Thus, both aztreonam/clindamycin and aztreonam/piperacillin therapy appear to be useful as empirical therapy for infections associated with hematologic disorders, and aztreonam/clindamycin proved to be more potent against the infections during the neutropenic period.
- 公益社団法人 日本化学療法学会の論文
公益社団法人 日本化学療法学会 | 論文
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