Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Intravenous Sulfamethoxazole-Trimethoprim Plus Ticarcillin as Empiric Antibiotic Therapy for Granulocytopenic Patients

Intravenous Sulfamethoxazole-Trimethoprim Plus Ticarcillin as Empiric Antibiotic Therapy for... Abstract Infection is particularly common during periods of prolonged, profound granulocytopenia, with most Gramnegative rod bacteremias occurring when the granulocyte count is less than 100/μL. The signs and symptoms of infection in granulocytopenic patients are minimal, making early detection of infection difficult. Fever, however, is nearly universal and represents the initial clue to infection in these patients. The presence of fever (temperature greater than 37.3 °C [101 °F]) and granulocytopenia (< 1,000 granulocytes per microliter) has been shown to be associated with infection in approximately 60% of cases, with 20% having a bacteremia. About two thirds of patients with bacteremia have Gram-negative rod bacteremia. The presence of a Gram-negative bacteremia has been associated with a mortality of 60% to 80% in many university hospital settings among patients with "rapidly fatal" underlying disease. However, the mortality for granulocytopenic patients with Gram-negative bacteremia treated in specialized cancer centers began to improve about ten References 1. Schimpff SC: Therapy of infection in patients with granulocytopenia. Med Clin North Am 61:1101-1118, 1977. 2. Keating MJ, Bodey GP, Valdivieso M, et al: A randomized comparative trial of three aminoglycosides: Comparison of continuous infusions of gentamicin, amikacin and sisomicin combined with carbenicillin in the treatment of infections in neutropenic patients with malignancies. Medicine 58:159-170, 1979.Crossref 3. Bodey GP, Whitecar JP Jr, Middleman E, et al: Carbenicillin therapy for Pseudomonas infection. JAMA 218:62-66, 1971.Crossref 4. Three antibiotic regimens in the treatment of infection in febrile granulocytopenic patients with cancer, The EORTC International Antimicrobial Therapy Project Group. J Infect Dis 137:14-29, 1978.Crossref 5. Klastersky J, Daneau D, Swings G, et al: Antibacterial activity in serum and urine as a therapeutic guide in bacterial infections. J Infect Dis 129:187-193, 1974.Crossref 6. Lau WK, Young LS, Winston DJ, et al: Comparative efficacy and toxicity of amikacin/carbenicillin versus gentamicin/carbenicillin in leukopenic patients: A randomized prospective trial. Am J Med 62:959-966, 1977.Crossref 7. Love LJ, Schimpff SC, Schiffer CA, et al: Improved prognosis for granulocytopenic patients with Gram-negative bacteremia. Am J Med 68:643-648, 1980.Crossref 8. Stuart RK, Braine HG, Lietman PS, et al: Carbenicillin-trimethoprim/ sulfamethoxazole versus carbenicillin-gentamicin as empiric therapy of infection in granulocytopenic patients: A prospective, randomized double-blind study. Am J Med 68:876-885, 1980.Crossref 9. Schimpff SC: Infection prevention during profound granulocytopenia: New approaches to alimentary canal microbial suppression. Ann Intern Med 93:358-361, 1980.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Intravenous Sulfamethoxazole-Trimethoprim Plus Ticarcillin as Empiric Antibiotic Therapy for Granulocytopenic Patients

Archives of Internal Medicine , Volume 141 (7) – Jun 1, 1981

Loading next page...
 
/lp/american-medical-association/intravenous-sulfamethoxazole-trimethoprim-plus-ticarcillin-as-empiric-uPvUfs8pcj

References (9)

Publisher
American Medical Association
Copyright
Copyright © 1981 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1981.00340070024006
Publisher site
See Article on Publisher Site

Abstract

Abstract Infection is particularly common during periods of prolonged, profound granulocytopenia, with most Gramnegative rod bacteremias occurring when the granulocyte count is less than 100/μL. The signs and symptoms of infection in granulocytopenic patients are minimal, making early detection of infection difficult. Fever, however, is nearly universal and represents the initial clue to infection in these patients. The presence of fever (temperature greater than 37.3 °C [101 °F]) and granulocytopenia (< 1,000 granulocytes per microliter) has been shown to be associated with infection in approximately 60% of cases, with 20% having a bacteremia. About two thirds of patients with bacteremia have Gram-negative rod bacteremia. The presence of a Gram-negative bacteremia has been associated with a mortality of 60% to 80% in many university hospital settings among patients with "rapidly fatal" underlying disease. However, the mortality for granulocytopenic patients with Gram-negative bacteremia treated in specialized cancer centers began to improve about ten References 1. Schimpff SC: Therapy of infection in patients with granulocytopenia. Med Clin North Am 61:1101-1118, 1977. 2. Keating MJ, Bodey GP, Valdivieso M, et al: A randomized comparative trial of three aminoglycosides: Comparison of continuous infusions of gentamicin, amikacin and sisomicin combined with carbenicillin in the treatment of infections in neutropenic patients with malignancies. Medicine 58:159-170, 1979.Crossref 3. Bodey GP, Whitecar JP Jr, Middleman E, et al: Carbenicillin therapy for Pseudomonas infection. JAMA 218:62-66, 1971.Crossref 4. Three antibiotic regimens in the treatment of infection in febrile granulocytopenic patients with cancer, The EORTC International Antimicrobial Therapy Project Group. J Infect Dis 137:14-29, 1978.Crossref 5. Klastersky J, Daneau D, Swings G, et al: Antibacterial activity in serum and urine as a therapeutic guide in bacterial infections. J Infect Dis 129:187-193, 1974.Crossref 6. Lau WK, Young LS, Winston DJ, et al: Comparative efficacy and toxicity of amikacin/carbenicillin versus gentamicin/carbenicillin in leukopenic patients: A randomized prospective trial. Am J Med 62:959-966, 1977.Crossref 7. Love LJ, Schimpff SC, Schiffer CA, et al: Improved prognosis for granulocytopenic patients with Gram-negative bacteremia. Am J Med 68:643-648, 1980.Crossref 8. Stuart RK, Braine HG, Lietman PS, et al: Carbenicillin-trimethoprim/ sulfamethoxazole versus carbenicillin-gentamicin as empiric therapy of infection in granulocytopenic patients: A prospective, randomized double-blind study. Am J Med 68:876-885, 1980.Crossref 9. Schimpff SC: Infection prevention during profound granulocytopenia: New approaches to alimentary canal microbial suppression. Ann Intern Med 93:358-361, 1980.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 1, 1981

There are no references for this article.