Efficacy of continuous infusion of ceftazidime for patients with neutropenic fever after high-dose chemotherapy and peripheral blood stem cell transplantation
Neutropenia is an important complication of high-dose chemotherapy (HDCT). Neutropenic patients presenting with fever are routinely hospitalized for treatment with broad-spectrum antibiotics. Neutropenia up to 10 days is associated with a low-risk profile, and antimicrobial therapy administered on a...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
July 2000
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| In: |
International journal of antimicrobial agents
Year: 2000, Volume: 15, Issue: 2, Pages: 119-123 |
| ISSN: | 1872-7913 |
| DOI: | 10.1016/S0924-8579(00)00155-2 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/S0924-8579(00)00155-2 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0924857900001552 
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| Author Notes: | Gerlinde Egerer, Hartmut Goldschmidt, Hans Salwender, Ute Hegenbart, Ingrid Ehrhard, Rainer Haas, Anthony D Ho |
| Summary: | Neutropenia is an important complication of high-dose chemotherapy (HDCT). Neutropenic patients presenting with fever are routinely hospitalized for treatment with broad-spectrum antibiotics. Neutropenia up to 10 days is associated with a low-risk profile, and antimicrobial therapy administered on an outpatient basis might be an alternative to admission to hospital. This prospective study evaluates the safety of a continuous infusion of ceftazidime in neutropenic patients after HDCT and peripheral blood stem cell transplantation (PBSCT). From September 1995 to October 1999, 81 patients received a 2 g intravenous bolus of ceftazidime, followed by a 4 g continuous infusion per 24 h of ceftazidime using a portable infusion pump. If the fever persisted for 72 h, a glycopeptide antibiotic was added. The median patients’ age was 44 years. Fifty-two of 81 patients (64%) responded to the monotherapy with ceftazidime. After addition of a glycopeptide antibiotic, a further 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 treatment alone. The reason for admission to hospital was the change to imipenem/cilastin, which had to be administered three times per day (12 patients), severe mucositis with parenteral nutrition (eight patients), or a Karnovsky index ≤60 (three patients). In six of these cases, outpatient treatment was resumed after a brief period of in-patient care. In no case was the treatment terminated because of failure of the pump. With daily follow-up and close monitoring for development of complications, it is possible to discharge patients earlier after HDCT and PBSCT, thereby decreasing costs. |
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| Item Description: | Gesehen am 21.12.2021 |
| Physical Description: | Online Resource |
| ISSN: | 1872-7913 |
| DOI: | 10.1016/S0924-8579(00)00155-2 |