Lacka J, Oravcova E, Sevcikova L, Studena M, Bachanova V, Kukuckova E, Spanik S, Sufliarsky J, Helpianska L, Trupl J, Kunova A, Vochyanova I, Sycova Z, Grey E, Krcméry V
Department of Chemotherapy, Postgraduate Medical School, Bratislava, Republic of Slovakia.
Chemotherapy. 1996 Mar-Apr;42(2):146-9. doi: 10.1159/000239434.
137 patients with febrile neutropenia after cytotoxic therapy not responding to ceftazidime plus or ceftriaxone plus netilmicin in received additionally to the previous combination either vancomycin alone or combined with another anti-gram-negative compound: imipenem in those treated prophylactically with ofloxacin and ciprofloxacin in those without prophylaxis. The addition of vancomycin to the previously ineffective combination of a third generation cephalosporin plus aminoglycoside, and replacement of ceftriaxone plus netilmicin with ceftazidime plus amikacin plus vancomycin or with ceftazidime plus vancomycin seems to be less effective (71.8-75 vs. 87.5-90.9%, p < 0.02) and more toxic (20.5-7.2 vs. 0-5%, p < 0.0005) than vancomycin in combination with a different anti-gram-negative compound as previously used: imipenem or ciprofloxacin.
137例细胞毒性治疗后出现发热性中性粒细胞减少且对头孢他啶加或头孢曲松加奈替米星无反应的患者，在先前联合用药基础上，要么单独加用万古霉素，要么与另一种抗革兰阴性菌化合物联合使用：接受氧氟沙星预防性治疗的患者加用亚胺培南，未进行预防性治疗的患者加用环丙沙星。在先前无效的第三代头孢菌素加氨基糖苷类联合用药基础上加用万古霉素，以及用头孢他啶加阿米卡星加万古霉素或头孢他啶加万古霉素替代头孢曲松加奈替米星，似乎比万古霉素与先前使用的不同抗革兰阴性菌化合物（亚胺培南或环丙沙星）联合使用效果更差（71.8 - 75%对87.5 - 90.9%，p < 0.02）且毒性更大（20.5 - 7.2%对0 - 5%，p < 0.0005）。
