[Combination of a 3d-generation cephalosporin (cefotaxime or ceftazidime) and a new quinolone (pefloxacine) in the treatment of febrile episodes in neutropenic diseases (37 cases)]

Presse Med. 1987 Dec 16;16(43):2172-5.
[Article in French]

Abstract

The combination of beta-lactam antibiotics and new quinolones is a form of broad spectrum antibiotic therapy rapidly bactericidal in vitro which could be an alternative to the classical combination of beta-lactam antibiotics and aminoglycosides in the first line treatment of febrile episodes in patients with neutropenia. The treatment of 37 initial febrile episodes (12 cases of septicemia, 7 infectious sites and 38 cases of fever of unknown origin) in 33 neutropenic patients (PMN leucocytes less than 500/mm3) using the combination of a third generation cephalosporin (cefotaxime or ceftazidime) and a new quinolone (pefloxacin) resulted in an 86% immediate success rate (32 cases/37). Results and course during treatment were similar in both groups (cefotaxime or ceftazidime). A second febrile episode occurred in 11 cases (4 superinfections, 2 chest infections, 5 fevers of unknown origin). Clinical acceptability was satisfactory in both groups. Minimal and transient changes in liver function tests were observed in 19% of the successfully treated patients. Study of quantitative aerobic stool cultures revealed the emergence of resistant bacterial strains, essentially Pseudomonas sp. (6 cases). More extensive trials should provide a better view of the role of this new combination in the first line treatment of febrile episodes in the neutropenic patient.

Publication types

  • Clinical Trial
  • English Abstract
  • Randomized Controlled Trial

MeSH terms

  • Agranulocytosis / complications*
  • Anti-Infective Agents / therapeutic use*
  • Cefotaxime / therapeutic use*
  • Ceftazidime / therapeutic use*
  • Drug Evaluation
  • Drug Therapy, Combination
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / etiology
  • Escherichia coli Infections / microbiology
  • Feces / microbiology
  • Fever / drug therapy*
  • Fever / etiology
  • Fever / microbiology
  • Focal Infection / drug therapy
  • Focal Infection / etiology
  • Focal Infection / microbiology
  • Humans
  • Leukemia / complications
  • Neutropenia / complications*
  • Neutropenia / drug therapy
  • Neutropenia / etiology
  • Neutropenia / microbiology
  • Norfloxacin / analogs & derivatives*
  • Norfloxacin / therapeutic use
  • Pefloxacin
  • Pseudomonas Infections / drug therapy
  • Pseudomonas Infections / etiology
  • Pseudomonas Infections / microbiology
  • Sepsis / drug therapy
  • Sepsis / etiology
  • Sepsis / microbiology
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / etiology
  • Staphylococcal Infections / microbiology

Substances

  • Anti-Infective Agents
  • Pefloxacin
  • Ceftazidime
  • Norfloxacin
  • Cefotaxime