Nucci M, Biasoli I, Braggio S, Portugal R, Schaffel R, Maiolino A, Loureiro M M, Spector N, Pulcheri W
Hematology Service, University Hospital, Universidade Federal do Rio de Janeiro, 21941-590, Rio de Janeiro, Brazil.
Oncol Rep. 1998 Sep-Oct;5(5):1205-9. doi: 10.3892/or.5.5.1205.
A prospective randomized trial was performed to compare teicoplanin to vancomycin as part of the empirical antibiotic therapy of febrile neutropenic cancer patients. Fifty-three patients were randomized to receive ceftazidime (100 mg/kg daily every 8 h), amikacin (15 mg/kg daily every 8 h) and teicoplanin (6 mg/kg once a day) and 53 other patients received ceftazidime, amikacin (same dosages) and vancomycin (30 mg/kg/day every 6 h). In 99 evaluable episodes, the success rates were 54% for patients receiving teicoplanin and 52% for patients receiving vancomycin (p=0.76, 95% CI-18-23). The response rates were similar for patients with unexplained fever and for patients with documented infections. There were no differences in renal toxicity or cutaneous side effects between the two groups. The overall death rate was 18.9%, with 10 deaths in each group. The most important factor associated with death was the diagnosis of a fungal infection (p=0.001). Teicoplanin seems to be well tolerated and as effective as vancomycin in the empirical antibiotic therapy of fever in neutropenic cancer patients.
进行了一项前瞻性随机试验，比较替考拉宁与万古霉素作为发热性中性粒细胞减少癌症患者经验性抗生素治疗的一部分。53例患者被随机分配接受头孢他啶（每8小时100mg/kg每日）、阿米卡星（每8小时15mg/kg每日）和替考拉宁（每日一次6mg/kg），另外53例患者接受头孢他啶、阿米卡星（相同剂量）和万古霉素（每6小时30mg/kg/天）。在99个可评估的病例中，接受替考拉宁的患者成功率为54%，接受万古霉素的患者成功率为52%（p = 0.76，95%CI - 18 - 23）。不明原因发热患者和有明确感染患者的反应率相似。两组之间肾毒性或皮肤副作用无差异。总死亡率为18.9%，每组各有10例死亡。与死亡相关的最重要因素是真菌感染的诊断（p = 0.001）。在中性粒细胞减少癌症患者发热的经验性抗生素治疗中，替考拉宁似乎耐受性良好且与万古霉素效果相当。
