Safety and Efficacy of Cefoperazone Plus Sulbactam versus Ceftazidime in the Empiric Treatment of Febrile Neutropenia

1998 ◽  
Vol 14 (2) ◽  
pp. 63-69 ◽  
Author(s):  
Pranatharthi H Chandrasekar
Keyword(s):  
Febrile Neutropenia ◽  
Clinical Success ◽  
Empiric Therapy ◽  
Clinical Response Rate ◽  
Gram Positive ◽  
Safety And Efficacy ◽  
Empiric Treatment ◽  
Transient Elevation ◽  
Gram Positive Cocci

Objective: To compare the safety and efficacy of cefoperazone plus sulbactam (CPZ + SB) (3 g [2:1] every 8 h) and ceftazidime (CTZ) (2 g every 8 h) as monotherapy in the empiric treatment of febrile neutropenia in patients with cancer. Patients: One hundred eighteen cancer patients with chemotherapy-associated neutropenia and fever. Most patients (82) received norfloxacin and fluconazole as prophylaxis. Results: Fifty-nine patients were enrolled in the CPZ + SB group, and 59 were enrolled in the CTZ group. The mean duration of antibiotic therapy was less than 10 days in both groups. Forty-three patients (19 in the CPZ + SB group and 24 in the CTZ group) were bacteremic, and 7 others had cellulitis. Of the 56 microorganisms producing bacteremia, 51 were gram-positive bacteria, mostly staphylococci (28 isolates) and streptococci (22 isolates). Gram-positive cocci were more frequently resistant to CTZ than to CPZ + SB (77% vs. 40%, respectively; p < 0.002). However, the clinical response rate at 72 hours of therapy was 53% in the CPZ + SB group and 52% in the CTZ group (p = 1.0). At the end of therapy, clinical responses were similar in the two groups (p = 0.19). Clinical success with antibiotic modification was seen in 42% of the CPZ + SB recipients and in 58% of CTZ recipients (p = 0.10). Bacteriologic eradication among bacteremic patients appeared to be slightly better in the CPZ + SB group (79% vs. 54%; p = 0.09). Except for rashes in 3 patients (1 in the CPZ + SB group and 2 in the CTZ group), both drugs were well tolerated. Adverse events included superinfections, transient elevation of serum transaminase concentrations, diarrhea, and chills. Conclusions: CPZ + SB was superior to CTZ in its in vitro activity against aerobic gram-positive cocci encountered in the study; however, the clinical efficacy and safety of the two drug treatments were similar in the empiric therapy for febrile neutropenia.

scholarly journals Comparison of Activities of Broad-Spectrum β-Lactam Compounds against 1,128 Gram-Positive Cocci Recently Isolated in Cancer Treatment Centers

1999 ◽  
Vol 43 (4) ◽  
pp. 940-943 ◽  
Author(s):  
Daniel J. Diekema ◽  
Stacy L. Coffman ◽  
Steven A. Marshall ◽  
Mondell L. Beach ◽  
Kenneth V. I. Rolston ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Broad Spectrum ◽  
Empiric Therapy ◽  
Gram Positive ◽  
Gram Positive Cocci

ABSTRACT We report the in vitro activities of broad-spectrum β-lactam antimicrobials tested against 1,128 gram-positive pathogens recently isolated from cancer patients. Cefepime and imipenem were more active than ceftazidime and ceftriaxone against these organisms. Only vancomycin demonstrated reliable activity against oxacillin-resistant staphylococci, Enterococcus spp., andCorynebacterium spp. The spectrum of gram-positive organisms against which cefepime and imipenem have activity provides an advantage over ceftazidime as empiric therapy for cancer patients, potentially reducing the need for the empiric addition of glycopeptides.

In vitro activity of telavancin and comparators against selected groups of Gram-positive cocci

2013 ◽  
Vol 41 (3) ◽  
pp. 213-217 ◽  
Author(s):  
Russell Hope ◽  
Aiysha Chaudhry ◽  
Rachael Adkin ◽  
David M. Livermore
Keyword(s):  
Vitro Activity ◽  
In Vitro Activity ◽  
Gram Positive ◽  
Gram Positive Cocci

Comparative in vitro activity of ceftobiprole against Gram-positive cocci

2010 ◽  
Vol 36 (2) ◽  
pp. 111-113 ◽  
Author(s):  
Carmen Betriu ◽  
Esther Culebras ◽  
María Gómez ◽  
Fátima López-Fabal ◽  
Iciar Rodríguez-Avial ◽  
...  
Keyword(s):  
Vitro Activity ◽  
In Vitro Activity ◽  
Gram Positive ◽  
Gram Positive Cocci

Działanie in vitro olejku cyprysowego (Oleum Cupressi) na bakterie beztlenowe

2019 ◽  
Vol 20 (2) ◽  
Author(s):  
Anna Kędzia ◽  
Elżbieta Hołderna-Kędzia
Keyword(s):  
Anaerobic Bacteria ◽  
Growth Control ◽  
Cupressus Sempervirens ◽  
Tannerella Forsythia ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Gram Positive Cocci ◽  
Porphyromonas Levii

Introduction. Cypress (Cupressus sempervirens L.) belongs to the family Cupressaceae. It is evergreen, and grows in Mediterranean region. The Cypress leaves and young branches are utilized to produce the essential oil. Cypress oil contain a number of components, in it α-pinene, Δ3-carene, α-terpinyl acetate, cedrol, α-terpinolene, β-myrcene, limonene, α-terpineolene, terpinen-4-ol, β-pinene, δ-cadinene and sabinene. The oil is used in therapy different diseases. It to have antimicrobial activity. Aim. The aim of the date was evaluation the susceptibility of anaerobic bacteria to Cypress oil. Material and methods. The anaerobic bacteria were isolated from patients. The 62 microorganisms, in it 36 strains of Gram-negative rods, 14 Gram-positive cocci and 12 Gram-positive rods, and 7 reference strains were tested. Susceptibility (MIC) was determined by means of plate dilution technique in Brucella agar supplemented with 5% defibrynated sheep blood, menadione and hemin. The Cypress oil was dissolved in DMSO and distilled water to obtain final following concentrations: 2.5, 5.0, 7.5, 10.0, 15.0 and 20.0 mg/ml. Inoculum containing 106 CFU per 1 ml was seeded with Steers replicator upon the agar with oil or without the oil (strains growth control). The agar plates was incubated in anaerobic condition in anaerobic jar in 37°C for 48 hrs. The MIC was interpreted as the lowest concentration of Cypress oil inhibiting the growth of tested bacteria. Results. The results indicated that from among Gram-negative rods the most susceptible to Cypress oil was the strains from genus Tannerella forsythia (MIC < 2.5-5.0 mg/ml), Bacteroides uniformis (MIC = 5.0 mg/ml), Bacteroides vulgatus and Porphyromonas asaccharolytica (MIC 5.0-7.5 mg/ml) and Porphyromonas levii (MIC = 7.5 mg/ml). The strains from genera Fusobacterium and of Bacteroides fragilis were the susceptible to 2.5-≥ 20.0 mg/ml. The Cypress oil was least active towards Prevotella and Parabacteroides strains (MIC ≥ 20.0 mg/ml).The tested Gram-positive cocci were more susceptible. The growth of the strains were inhibited by concentrations in ranges ≤ 2.5-7.5 mg/ml. The oil was minor active towards Gram-positive rods (MIC ≤ 2.5-20.0 mg/ml). Among the strains the genus of Actinomyces odontolyticus (MIC = 5.0 mg/ml) and Actinomyces viscosus (MIC ≤ 2.5-7.5 mg/ml) were the most susceptible. The growth of rods of Bifidobacterium breve was inhibited by concentrations 10.0 mg/ml. The data indicates that the Gram-negative rods were the less susceptible than Gram-positive bacteria to cypress oil. Conclusions. Among Gram-negative rods the most susceptible were the strains Tannerella forsythia, Bacteroides uniformis, Bacteroides vulgatus, Porphyromonas asaccharolytica and Porphyromonas levii. The oil was more active against Gram-positive cocci. Gram-positive anaerobic bacteria demonstrate the more susceptible to Cypress oil then Gram-positive rods.

scholarly journals In Vitro Activity of Aurein 1.2 Alone and in Combination with Antibiotics against Gram-Positive Nosocomial Cocci

2007 ◽  
Vol 51 (4) ◽  
pp. 1494-1496 ◽  
Author(s):  
Andrea Giacometti ◽  
Oscar Cirioni ◽  
Alessandra Riva ◽  
Wojciech Kamysz ◽  
Carmela Silvestri ◽  
...  
Keyword(s):  
Vitro Activity ◽  
In Vitro Activity ◽  
Gram Positive ◽  
Gram Positive Cocci ◽  
Aurein 1.2

ABSTRACT This study was performed to evaluate the in vitro activity of the amphibian peptide aurein 1.2 and to investigate its interaction with six antibiotics against nosocomial gram-positive cocci. All isolates were inhibited at concentrations of 1 to 16 mg/liter. Synergy was demonstrated when aurein 1.2 was combined with clarithromycin and minocycline.

In vitro activity of sparfloxacin, ciprofloxacin, ofloxacin, and other antibiotics against bloodstream isolates of gram-positive cocci

1993 ◽  
Vol 17 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Coleman Rotstein ◽  
Daniel Amsterdam ◽  
Thomas R. Beam ◽  
Lionel A. Mandell ◽  
Eugene A. Gorzynski
Keyword(s):  
Vitro Activity ◽  
In Vitro Activity ◽  
Gram Positive ◽  
Gram Positive Cocci
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