甲氧苄啶-磺胺甲恶唑预防中性粒细胞减少患者感染。欧洲癌症研究与治疗组织国际抗菌治疗项目组。

Trimethoprim-sulfamethoxazole in the prevention of infection in neutropenic patients. EORTC International Antimicrobial Therapy Project Group.

出版信息

J Infect Dis. 1984 Sep;150(3):372-9. doi: 10.1093/infdis/150.3.372.

DOI:10.1093/infdis/150.3.372

Abstract

Of 545 patients expected to develop prolonged neutropenia and randomized to received trimethoprim-sulfamethoxazole (TMP-SMZ) or placebo, 342 were evaluable for occurrence of infection or bacteremia. Some centers used oral nonabsorbable antibiotics in addition. Infection occurred in 64 (39%) of 165 placebo recipients and 46 (26%) of 177 TMP-SMZ recipients (P = .016), whereas bacteremia occurred in 32 (19%) and 22 (12%), respectively (P = .106, difference not significant [NS]). In the 139 patients with acute nonlymphocytic leukemia (ANLL), infection occurred in 35 (55%) of 64 placebo-treated patients and 31 (41%) of 75 TMP-SMZ-treated patients (P = .162, NS), whereas bacteremia occurred in 15 (23%) and 18 (24%; NS), respectively. Excluding patients with ANLL, infection occurred in 29 (29%) of 101 placebo-treated patients and 15 (15%) of 102 TMP-SMZ recipients (P = .038), whereas bacteremia occurred in 17 (17%) and four (4%; P = .005), respectively. Gram-positive cocci were isolated less frequently from TMP-SMZ-treated, bacteremic patients, but more of their isolates were resistant to TMP-SMZ than were those from placebo recipients.

摘要

在预计会发生长期中性粒细胞减少并随机接受甲氧苄啶-磺胺甲恶唑（TMP-SMZ）或安慰剂治疗的545例患者中，有342例可评估感染或菌血症的发生情况。一些中心还使用了口服不吸收抗生素。165例接受安慰剂治疗的患者中有64例（39%）发生感染，177例接受TMP-SMZ治疗的患者中有46例（26%）发生感染（P = 0.016），而菌血症分别发生在32例（19%）和22例（12%）患者中（P = 0.106，差异无统计学意义[NS]）。在139例急性非淋巴细胞白血病（ANLL）患者中，64例接受安慰剂治疗的患者中有35例（55%）发生感染，75例接受TMP-SMZ治疗的患者中有31例（41%）发生感染（P = 0.162，NS），而菌血症分别发生在15例（23%）和18例（24%；NS）患者中。排除ANLL患者后，101例接受安慰剂治疗的患者中有29例（29%）发生感染，102例接受TMP-SMZ治疗的患者中有15例（15%）发生感染（P = 0.038），而菌血症分别发生在17例（17%）和4例（4%；P = 0.005）患者中。在接受TMP-SMZ治疗的菌血症患者中，革兰氏阳性球菌的分离频率较低，但与接受安慰剂治疗的患者相比，其分离株对TMP-SMZ的耐药性更高。