Do double-β-lactam combinations prolong neutropenia in patients undergoing chemotherapy or bone marrow transplantation for hematological disease?

C. C. Kibbler, H. G. Prentice, R. J. Sage, A. V. Hoffbrand, M. K. Brenner, P. Noone

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

The total period of neutropenia was assessed in 174 episodes after chemotherapy or bone marrow transplantation in which patients received antibiotics for fever in a randomized prospective trial. Log rank analysis demonstrated no significant difference in the total duration of neutropenia between patients receiving netilmicin plus either piperacillin or azlocillin and those given ceftazidime plus either piperacillin or azlocillin. Of 86 patients in the single-β-lactam group, 27 had a persistent neutrophil count of 0.1 x 109 per liter during treatment compared with 27 of 88 patients in the double-β-lactam group, and 29 of 68 patients treated with the single-β-lactam combination had a total period of neutropenia greater than 30 days versus 36 of 75 in the double-β-lactam group. The use of two β-lactam antibiotics rather than one does not appear to prolong neutropenia in patients undergoing treatment of hematological malignancy. However, in order to determine the effect of a single-β-lactam combination, a similar carefully controlled prospective randomized study in which such treatment is compared with a non-β-lactam-containing regimen is required.

Original languageEnglish (US)
Pages (from-to)503-507
Number of pages5
JournalAntimicrobial Agents and Chemotherapy
Volume33
Issue number4
DOIs
StatePublished - 1989

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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