A Randomized Study of Tobramycin Plus Ticarcillin, Tobramycin Plus Cephalothin and Ticarcillin, or Tobramycin Plus Mezlocillin in the Treatment of Infection in Neutropenic Patients with Malignancies

Lawson, Ronald D.; Gentry, Layne O.; Bodey, Gerald P.; Keating, Michael J.; Smith, Terry L.

doi:10.1097/00000441-198401000-00004

Cited by 51 publications

(11 citation statements)

References 30 publications

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“…The group that received imipenem had slightly better clinical responses overall, but this was not statistically significant (Winston et al, 1991). All patients with a documented Gram-negative infection who received imipenem clinically improved, but similar to many of the comparisons in other studies (File and Tan, 1983;Lawson et al, 1984;Menichetti et al, 1987Menichetti et al, , 1990Winston et al, 1991), small patient populations made both statistical and clinical significance difficult to determine.…”

Section: Dual Beta-lactam Versus Mono Beta-lactam Therapymentioning

confidence: 53%

Dual beta-lactam therapy for serious Gram-negative infections: is it time to revisit?

Rahme

Butterfield

Nicasio

et al. 2014

Diagnostic Microbiology and Infectious Disease

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Section: Dual Beta-lactam Versus Mono Beta-lactam Therapymentioning

confidence: 53%

Dual beta-lactam therapy for serious Gram-negative infections: is it time to revisit?

Rahme

Butterfield

Nicasio

et al. 2014

Diagnostic Microbiology and Infectious Disease

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“…39 In a clinical study, the initial evaluation of febrile neutropenic patients for the presence of infection was erroneous in 33% of patients. 40 Hence, physicians should perform a meticulous physical examination and should take notice of every minor and subtle sign and symptom of infection and investigate them further when assessing patients with febrile neutropenia. A focused physical examination should be repeated daily if the symptoms persist and always should include examination of the skin, skin folds, genitalia, anal area, sinuses, oropharynx, and fundi.…”

Section: Physical Examinationmentioning

confidence: 99%

Perspectives for the management of febrile neutropenic patients with cancer in the 21st century

Sipsas

Bodey

Kontoyiannis

2005

Cancer

Self Cite

139

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Over the past several decades, there has been substantial progress in the management of patients with febrile neutropenia. However, the ever-changing patterns of infection, ecology, and antibiotic-resistance trends do not allow the development of treatment guidelines that could be applied universally. Hence, the institution's predominant pathogens and resistance patterns should guide the empirical choice of antimicrobials. Prompt initiation of antimicrobial therapy remains the gold standard. Monotherapy with the newer broad-spectrum antimicrobials has tended to replace the classic combination therapy. Empirical administration of glycopeptides, such as vancomycin, without documentation of a gram-positive infection is not favored. The development of risk-stratification models has allowed for identification of low-risk patients with additional treatment options, such as early discharge and exclusively outpatient treatment with oral antimicrobials. The initiation of empirical antifungal therapy in persistently febrile neutropenic patients has become common practice, especially recently, since the introduction of new, effective, less toxic antifungal drugs. It is hoped that the development of new nonculture-based diagnostic methods will allow for the early detection of invasive fungal infections and, thus, the replacement of empirical antifungal therapy with pathogen-specific, preemptive therapy.

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“…Three-drug regimens have not proved to be more effective than two-drug regimens (13,14). The concept of combining two P-lactam antibiotics was introduced in 1969, and many studies have indicated that these regimens are as effective as a P-lactam plus an aminoglycoside (4,8,17,21).…”

mentioning

confidence: 99%

Imipenem-cilastatin as initial therapy for febrile cancer patients

Bodey¹,

Álvarez²,

Jones³

et al. 1986

Antimicrob Agents Chemother

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Imipenem-cilastatin was used to treat 79 febrile episodes in 71 cancer patients, most of whom had neutropenia. The overall response rate was 67%, and 76% of the 45 documented infections responded. The response rates for septicemias and pneumonias were 79 and 62%, respectively. Only 1 of the 17 infections caused by gram-negative bacilli failed to respond to this therapy. The most common side effects were skin rash, nausea, and diarrhea. Eight superinfections were detected during therapy.

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A Randomized Study of Tobramycin Plus Ticarcillin, Tobramycin Plus Cephalothin and Ticarcillin, or Tobramycin Plus Mezlocillin in the Treatment of Infection in Neutropenic Patients with Malignancies

Cited by 51 publications

References 30 publications

Dual beta-lactam therapy for serious Gram-negative infections: is it time to revisit?

Dual beta-lactam therapy for serious Gram-negative infections: is it time to revisit?

Perspectives for the management of febrile neutropenic patients with cancer in the 21st century

Imipenem-cilastatin as initial therapy for febrile cancer patients

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