Murase T
Department of Internal Medicine, Second Tokyo National Hospital.
Kansenshogaku Zasshi. 1992 Feb;66(2):121-6. doi: 10.11150/kansenshogakuzasshi1970.66.121.
Fourty-two febrile episodes of 32 patients with hematologic disease during neutropenia were treated with two randomly assigned antibiotic combinations of either piperacillin plus gentamicin or piperacillin plus aztreonam. Eleven of the 22 febrile episodes treated with piperacillin plus gentamicin and 12 of the 20 febrile episodes treated with piperacillin plus aztreonam responded. Addition of cefamandole to non-responders improved the outcome in 2 of the 16 febrile episodes. Mean nadir leucocyte count, age, sex, and underlying disease were not significantly different in both groups. Side effects were tolerable in both groups, although 1 patient treated with piperacillin plus gentamicin showed severe renal impairment. Piperacillin plus aztreonam is as effective as piperacillin plus gentamicin as an empiric antibiotic combination in the treatment of febrile episodes with hematologic disease during neutropenia.
32例血液系统疾病患者在中性粒细胞减少期间发生了42次发热，将其随机分为两组，分别接受两种抗生素联合治疗，即哌拉西林加庆大霉素或哌拉西林加氨曲南。在接受哌拉西林加庆大霉素治疗的22次发热中，有11次有反应；在接受哌拉西林加氨曲南治疗的20次发热中，有12次有反应。对无反应者加用头孢孟多后，16次发热中有2次病情好转。两组患者的平均最低白细胞计数、年龄、性别和基础疾病无显著差异。两组的副作用均可耐受，尽管1例接受哌拉西林加庆大霉素治疗的患者出现了严重的肾功能损害。在治疗中性粒细胞减少期间血液系统疾病的发热时，哌拉西林加氨曲南作为经验性抗生素联合用药与哌拉西林加庆大霉素一样有效。
