Format

Send to

Choose Destination
Infect Control Hosp Epidemiol. 2000 Jan;21(1 Suppl):S4-8.

A pilot study of antibiotic cycling in a hematology-oncology unit.

Author information

1
Department of Medicine, University of Nebraska Medical Center, Omaha, USA.

Abstract

OBJECTIVE:

To determine the safety and treatment efficacy of cycling antibiotic regimens for prophylaxis or treatment of patients with profound neutropenia.

DESIGN:

A prospective, nonrandomized, observational trial.

SETTING:

A 20-bed adult hematology-oncology inpatient unit at a university referral hospital.

PATIENTS:

Hospitalized adult patients with chemotherapy- or radiation-induced neutropenia (absolute neutrophil count less than 500 cells/mm3).

INTERVENTION:

Between July 1994 and January 1996, 295 hospitalized patients were evaluated on an intent-to-treat basis for the cycling protocol. Of these, 271 were eligible and assigned to one of four antibiotic regimens being used at the time of enrollment: (1) ceftazidime+vancomycin; (2) imipenem; (3) aztreonam+cefazolin; (4) ciprofloxacin+clindamycin. Data on infection rates and types, and antibiotic resistance patterns, toxicity, and effectiveness were collected.

RESULTS:

Twenty-four patients were excluded. Of the 271 evaluable patients, 123 (42%) were able to complete treatment on the assigned regimen. Of the 148 patients (50%) unable to do so, the reasons for failure included persistent fever (79%), breakthrough bacteremia (14%), and drug toxicity (7%). The antibiotic susceptibility profiles over the study period showed no increase in resistance. However, there was a marked increase in enterococcal infections.

CONCLUSIONS:

Our data show no significant increase in side effects or decrease in efficacy while cycling antibiotics among neutropenic patients and thus support further study of its role.

PMID:
10654628
DOI:
10.1086/503166
[Indexed for MEDLINE]

Supplemental Content

Loading ...
Support Center