Related Experiment Videos
Amikacin and cephalothin: empiric regimen for granulocytopenic cancer patients
Abstract:
Amikacin (15 mg/kg per day) was used in combination with cephalothin (7 g/m(2) per day) as an empiric regimen for de novo febrile (>101 degrees F [38.3 degrees C]) episodes in 93 granulocytopenic (<1,000/mm(3)) cancer patients. Both drugs were given intravenously in four equal doses every 6 h. The response rate for all documented infections was 83%, including 11 of 17 (65%) bacteremias. Escherichia coli (14 cases) was the most common pathogen, whereas Pseudomonas aeruginosa (2 cases) caused fewer infections. Mean amikacin serum levels were 8.7 mug/ml at 1 h and 2.2 mug/ml at 5 h. Failure of bone marrow recovery in association with a bacteremia was a bad prognostic sign (only two of eight improving). Ototoxicity occurred in two (2%) patients, whereas presumed antibiotic-induced nephrotoxicity developed in six (7%) patients. Surveillance cultures (nose, gums axilla, and rectum) of all hospitalized patients revealed no significant change in the incidence of amikacin resistance. The combination of amikacin and cephalothin in this dose and schedule was safe and efficacious in these granulocytopenic patients.
Insights
This study found that combining amikacin and cephalothin is a safe and effective empiric treatment for febrile episodes in granulocytopenic cancer patients. The regimen showed an 83% response rate for infections, including bacteremia.
Area of Science:
- Oncology
- Infectious Diseases
- Pharmacology
Background:
- Febrile episodes in granulocytopenic cancer patients pose a significant risk.
- Empiric antibiotic therapy is crucial for managing these infections.
- Identifying effective and safe treatment regimens is essential.
Purpose of the Study:
- To evaluate the efficacy and safety of a combination regimen of amikacin and cephalothin.
- To assess the response rate in granulocytopenic cancer patients with febrile episodes.
- To monitor for adverse events and development of antibiotic resistance.
Main Methods:
- A prospective study involving 93 granulocytopenic cancer patients with febrile episodes.
- Administered amikacin (15 mg/kg/day) and cephalothin (7 g/m²/day) intravenously every 6 hours.
- Monitored infection response rates, pathogen prevalence, drug serum levels, and adverse events.
Main Results:
- An overall response rate of 83% for documented infections, including 65% for bacteremias.
- Escherichia coli was the most frequent pathogen; Pseudomonas aeruginosa was less common.
- Ototoxicity occurred in 2% and nephrotoxicity in 7% of patients; no significant increase in amikacin resistance was observed.
Conclusions:
- The combination of amikacin and cephalothin is a safe and efficacious empiric regimen for febrile episodes in granulocytopenic cancer patients.
- Failure of bone marrow recovery with bacteremia indicated a poor prognosis.
- The study did not reveal an increase in amikacin resistance with this therapeutic approach.