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[Clinical evaluation of combination therapy with aspoxicillin and ceftazidime for severe infections complicating
K Akasaka1, K Nasu, A Horiuchi
1Department of Internal Medicine, Osaka Red Cross Hospital.
Abstract:
Clinical effects of a combination therapy using aspoxicillin (ASPC) and ceftazidime (CAZ) were investigated in 88 patients with severe infections which were complicating hematological disorders. ASPC and CAZ were administered intravenously at daily doses of 8 g and 4 to 6 g, respectively, in 2 to 4 divided doses for at least 3 days. The treatment was markedly effective in 20 cases; effective in 31; fairly effective in 4; and ineffective in 33 cases. Seventy-seven patients with whom detailed data were obtained showed an efficacy rate of 63.6%. Bacteria were detected in 9 patients, from whom 10 strains were isolated. The results of bacteriological effects were: 3 strains disappeared, 1 decreased, 3 unchanged, and 3 unclear. The bacteriological eradication rate was 42.9%. Of the detected 10 strains, 3 were identified as Pseudomonas aeruginosa, with 2 of the 3 strains eradicated and 1 decreased. An evaluation of the relationship between clinical efficacies and neutrophil counts before and after the ASPC-CAZ combination therapy showed that the patients with 500/mm3 or higher neutrophil counts before the therapy or those with increased neutrophils after the therapy tended to be more responsive to the therapy. Side effects were observed in 4 patients, but all of them disappeared upon discontinuation of the therapy. The combination therapy with ASPC and CAZ appears to be useful for the treatment of severe infections complicating hematological disorders.
Insights
This study found that combining aspoxicillin (ASPC) and ceftazidime (CAZ) shows promise for treating severe infections in patients with hematological disorders. Higher neutrophil counts correlated with better treatment response.
Area of Science:
- Infectious Diseases
- Hematology
- Pharmacology
Context:
- Severe infections frequently complicate hematological disorders, posing significant treatment challenges.
- Existing therapies may have limitations in managing these complex cases.
Purpose:
- To evaluate the clinical efficacy and bacteriological effects of a combination therapy using aspoxicillin (ASPC) and ceftazidime (CAZ) in patients with severe infections secondary to hematological disorders.
Summary:
- A total of 88 patients received intravenous ASPC (8 g/day) and CAZ (4-6 g/day) for at least 3 days.
- An overall clinical efficacy rate of 63.6% was observed in 77 evaluable patients.
- Bacteriological eradication was achieved in 42.9% of detected bacterial strains, including Pseudomonas aeruginosa.
Impact:
- The combination therapy demonstrated potential utility in managing severe infections in this vulnerable patient population.
- Neutrophil counts were identified as a potential predictive factor for treatment response.
- Observed side effects were transient and resolved upon treatment discontinuation.