A Randomized Trial Comparing Ceftazidime Alone With Combination Antibiotic Therapy in Cancer Patients With Fever and Neutropenia

Pizzo, Philip A.; Hathorn, James W.; Hiemenz, John W.; Browne, Marcia; Commers, James R.; Cotton, Deborah; Gress, Janet; Longo, Dan L.; Marshall, Dorie; McKnight, John Edward; Rubin, Marc; Skelton, Jane; Thaler, Michael; Wesley, Robert

doi:10.1016/s0022-5347(17)44378-3

Cited by 99 publications

(97 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1,4,6,16,[38][39][40][41][42][43] It is possible that the high proportion of coagulase-negative staphylococcal BSI was due to the consideration of contaminants in blood cultures as true bacteremias. However, in this study, such an influence of contaminants is less likely since (1) our definition of BSI with common skin contaminants was rigorous (at least two positive consecutive cultures or two positive cultures within 72 h of one another) and in accordance with that used by other investigators; 1,4,6,16,[38][39][40][41][42][43] (2) the cultures were obtained in response to an indication of infection as opposed to carried out for surveillance; and (3) the common isolation of coagulase-negative staphylococcal from the blood is consistent with other studies. 2,6,44,45 It is more likely that the high proportion of coagulase-negative staphylococcal BSI was due to several factors including the presence of indwelling central venous catheters in virtually all of the patients in the early post-HSCT phase and the universal use of prophylaxis with fluoroquinolones.…”

Section: Discussionmentioning

confidence: 99%

Blood stream infection after hematopoietic stem cell transplantation is associated with increased mortality

Poutsiaka

Price

Ucuzian

et al. 2007

Bone Marrow Transplant

181

149

View full text Add to dashboard Cite

Blood stream infection (BSI) is a serious complication of hematopoietic stem cell transplantation (HSCT). The aim of this retrospective cohort analysis was to describe BSI after HSCT, and to assess the predictors and outcomes of BSI after HSCT using multivariable modeling. Of the 243 subjects transplanted, 56% received allogeneic HSCT and 106 (43.6%) developed BSI. Of the 185 isolates, 68% were Gram-positive cocci, 21% were Gram-negative bacilli (GNR) and 11% were fungi. Type of allogeneic HSCT was an independent risk factor for BSI (hazard ratio (HR) 3.26, 95% confidence interval (CI) 1.50, 7.07, P ¼ 0.01), as was the degree of HLA matching (HR 1.84, 95% CI 1.00, 3.37, P ¼ 0.05). BSI was a significant independent predictor of mortality after HSCT (HR 1.79, 95% CI 1.18, 2.73, P ¼ 0.007), after adjusting for acute graft-versus-host disease (GVHD) and allogeneic HSCT (both predicting death p3 months after HSCT). In contrast to the effects of acute GVHD and allogeneic HSCT, the effect of BSI was evident throughout the post-HSCT period. GNR BSI and vancomycin-resistant enterococcal BSI also were significantly associated with death. We concluded that BSI is a common complication of HSCT associated with increased mortality throughout the post-HSCT period.

show abstract

Section: Discussionmentioning

confidence: 99%

Blood stream infection after hematopoietic stem cell transplantation is associated with increased mortality

Poutsiaka

Price

Ucuzian

et al. 2007

Bone Marrow Transplant

181

149

View full text Add to dashboard Cite

show abstract

“…Single-agent treatments were employed as broad-spectrum b-lactames, such as ceftazidime and imipenem became available. Pizzo et al 13 published the first large-scale randomized study involving single-agent therapy. They compared ceftazidime singleagent therapy with the combination of carbenicillin, cephalotin and gentamicin.…”

Section: Discussionmentioning

confidence: 99%

Piperacillin/tazobactam vs ceftazidime in the treatment of neutropenic fever in patients with acute leukemia or following autologous peripheral blood stem cell transplantation: a prospective randomized trial

Harter

Schulze

Goldschmidt

et al. 2006

Bone Marrow Transplant

View full text Add to dashboard Cite

“…Febrile grade four (PMNp500 ml À1 ) neutropenia (FN) is a frequent complication of cancer chemotherapy, which causes death in 4 -21% of patients in large studies (The International Antimicrobial Therapy Group, 1978;Bodey, 1986;Pizzo et al, 1987;Talcott et al, 1992;Klastersky, 1993;Bodey et al, 1996;Segal et al, 2001). The risk of FN after administration of chemotherapy not only depends on the type and doses of drugs administered, but also on individual risk factors for each patient, such as performance status (PS), coexisting infections or underlying immunosuppression (Bodey, 1986;Klastersky, 1993;Bodey et al, 1996;Segal et al, 2001).…”

mentioning

confidence: 99%

Baseline and early lymphopenia predict for the risk of febrile neutropenia after chemotherapy

et al. 2003

View full text Add to dashboard Cite

A risk model for febrile neutropenia (FN) after conventional cytotoxic chemotherapy, based on early (day 5) lymphopenia and the dose of chemotherapy, has been described. A risk index based on parameters available at day 1 would be easier in daily practice. The objectives of this work were (1) to investigate a risk model for FN using only day 1 blood cell count and (2) to compare the day 1 and day 5 risk models. Three series of patients were used for the delineation and/or validation of these two risk models: (1) the exhaustive cohort of 950 patients treated in the Department of Medicine of the CLB in 1996 (CLB-1996 series), (2) the Elypse 1 series, a prospective series of 321 patients treated in community hospitals and regional cancer centres, and (3) a previously reported Elypse 0 series of 329 patients. Day 1 blood cell count was available in all three series, while day 5 blood cell count was available only in the Elypse 0 and 1 series. In the CLB-1996 series, 92 (9.7%) patients experienced FN; only chemotherapy dose and day 1 lymphopenia p700 ml À1 had an independent prognostic value for FN in multivariate analysis. In patients with both risk factors ('highrisk group'), the incidence of FN was 44, 50 and 61% in the CLB-1996. Elypse 1 and 0 series, respectively, indicating that the 'day 1' risk model enables one to identify patients at high-risk for FN. Besides, the observed incidence of FN in the high-risk group of the 'day 5' model (i.e. patients with day 5 lymphopenia p700 ml À1 and receiving high-risk CT) was 45 and 69% in the Elypse 0 and 1 series, respectively. In the Elypse 1 and 0 series, 15 and 12% of all patients who experienced FN were in the high-risk group of the 'day 1' risk model as compared to 25 and 62% for the high-risk group of the 'day 5' risk model. Both day 1 and day 5 lymphopenia are associated with an increased risk of FN in patients treated with chemotherapy. The 'day 1' model identifies a small population of patients at high risk for FN, but has a lower sensitivity than the day 5 model.

show abstract

A Randomized Trial Comparing Ceftazidime Alone With Combination Antibiotic Therapy in Cancer Patients With Fever and Neutropenia

Cited by 99 publications

References 0 publications

Blood stream infection after hematopoietic stem cell transplantation is associated with increased mortality

Blood stream infection after hematopoietic stem cell transplantation is associated with increased mortality

Piperacillin/tazobactam vs ceftazidime in the treatment of neutropenic fever in patients with acute leukemia or following autologous peripheral blood stem cell transplantation: a prospective randomized trial

Baseline and early lymphopenia predict for the risk of febrile neutropenia after chemotherapy

Contact Info

Product

Resources

About