Randomized comparison of sulbactam/cefoperazone with imipenem as empirical monotherapy for febrile granulocytopenic patients

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
D J WinstonM C Territo

Abstract

In a prospective, randomized, controlled trial, we compared sulbactam/cefoperazone with imipenem as empirical monotherapy for febrile, granulocytopenic patients; 101 patients received sulbactam/cefoperazone (2 g/4 g every 12 hours) and 102 patients received imipenem (500 mg every 6 hours). Documented infections were present in 40% of patients treated with sulbactam/cefoperazone (40 of 101) and in 39% of patients receiving imipenem (40 of 102). The number of pretherapy gram-positive pathogens (52 isolates) was twice the number of pretherapy gram-negative pathogens (26 isolates). The overall favorable clinical response rates for sulbactam/cefoperazone (91 of 103 patients, or 88%) and imipenem (84 of 104 patients, or 81%) were similar. Both drugs were generally well tolerated. However, diarrhea occurred more often in patients treated with sulbactam/cefoperazone (31 of 101 patients, or 31%, vs. 15 of 102 patients, or 15%; P = .007), while seizures developed only in patients receiving imipenem (0 of 101 patients vs. 3 of 102 patients, or 3%). Superinfections developed in 16% of patients in both study groups but were infrequently caused by beta-lactam-resistant gram-negative bacilli (two cases with sulbactam/cefoperazone therapy and ...Continue Reading

References

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Citations

Sep 28, 2004·Indian Journal of Pediatrics·Aditya H GaurJerry L Shenep
Jul 24, 2002·International Journal of Antimicrobial Agents·Satoshi IshiharaTakashi Deguchi
May 3, 2003·International Journal of Antimicrobial Agents·Jean A Klastersky
Feb 15, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·D J WinstonK J Tack
Jul 2, 2003·Drugs·Nelson LeeCyrus R Kumana
Apr 20, 2014·The Journal of Antimicrobial Chemotherapy·Joan P CannonShellee A Grim
May 16, 2002·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·A S Levin
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Nov 12, 2010·The Cochrane Database of Systematic Reviews·Mical PaulLeonard Leibovici
Oct 13, 2006·Current Opinion in Infectious Diseases·J Klastersky

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