Department of Gastroenterology and Hematology, Hokkaido University Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan.
Eur J Clin Microbiol Infect Dis. 2012 Feb;31(2):173-8. doi: 10.1007/s10096-011-1290-2. Epub 2011 May 19.
Despite the availability of newer classes of antibiotics, infection with multi-drug-resistant bacteria is a serious problem. To suppress the appearance of multi-drug-resistant bacteria and to avoid severe infection derived from febrile neutropenia (FN), we conducted cycling the administration of antibiotics for FN in patients with hematological malignancy. The treatment protocol consisted of the administration of four antibiotics each for 3 months in 1 year. The above regimen was repeated for 4 years. A total of 193 patients were registered in the protocol. The mean duration of the administration of cycling antibiotics was 5.9 days (range: 1-16 days). The frequency of FN before the study and during the study was unchanged until the third year, but decreased significantly in the fourth year. The frequency of detection of multi-drug-resistant bacteria in the first year was the same as that before the study was started, but dramatically decreased after the second year. Bacteriological treatment success rates were similar in each trimester and each year. The effective rate was not statistically different in each trimester and each year. We conclude that cycling the administration of antibiotics in patients with FN is useful for suppressing the appearance of multi-drug-resistant bacteria and for obtaining excellent clinical efficacy.
尽管有新的抗生素类别可供使用，但多重耐药菌感染仍然是一个严重的问题。为了抑制多重耐药菌的出现，并避免因发热性中性粒细胞减少症（FN）引起的严重感染，我们对血液恶性肿瘤患者的 FN 进行了抗生素循环治疗。该治疗方案包括在 1 年内每个月使用 4 种抗生素，每种抗生素使用 3 个月。该方案重复进行了 4 年。共有 193 名患者登记参与了该方案。循环抗生素治疗的平均持续时间为 5.9 天（范围：1-16 天）。在研究开始前和研究期间，FN 的发生频率直到第三年均未改变，但在第四年显著降低。在第一年检测到的多重耐药菌的频率与研究开始前相同，但第二年之后急剧下降。每个季度和每年的细菌学治疗成功率相似。每个季度和每年的有效率在统计学上没有差异。我们得出结论，对 FN 患者进行抗生素循环治疗有助于抑制多重耐药菌的出现，并获得出色的临床疗效。
