Combination antibiotic/rhG-CSF therapy for bacterially infected granulocytopenic patients |
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| Authors: | Keisuke Toyama Makoto Yaguchi Nobuyoshi Tsuruoka Ken-ichiro Hino Masanori Umeda Ken Shikoshi Yasuo Ikeda Takuro Shinbo Masao Kikuchi Nobuo Aoki Shinsaku Hirosawa Kiyoshi Izawa Isao Aoki |
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| Affiliation: | (1) Department of Hematology, Showa University School of Medicine, Tokyo, Japan;(2) First Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan;(3) Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan;(4) Department of Internal Medicine, The Second Tokyo National Hospital, Tokyo, Japan;(5) Department of Internal Medicine, Tachikawa Mutual Hospital, Tokyo, Japan;(6) First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan;(7) Department of Internal Medicine, Kosei Chuo General Hospital, Tokyo, Japan;(8) Second Department of Internal Medicine, Kyorin University, Tokyo, Japan;(9) First Department of Internal Medicine, Tokyo Medical College, 6-7-1, Nishi-shinjuku, Shinjuku-ku, 160 Tokyo, Japan |
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| Abstract: | A clinical efficacy rate of 80.8% was obtained in 26 severely infected patients, neutropenic as a result of hematologic disease, following three-drug combination therapy with sulbactam/cefoperazone (SBT/CPZ), piperacillin (PIPC), and human recombinant granulocyte colony stimulating factor (rhG-CSF). By day 4 of treatment, patients average body temperature decreased from 38.6±0.8°C to 37.1±0.7°C and their neutrophil counts increased from 298±347/μL to 1757±2239/μL. When compared with 31 similar patients previously treated with SBT/CPZ and PIPC but without rhG-CSF, the efficacy rate in this study was somewhat higher but the difference was not statistically significant. However, there were statistically significant differences in body temperature on day 4 (37.1±0.7°C vs. 37.8±1.0°C) and in duration of fever in responding cases (3.1±1.7 vs. 4.8±2.4 days). These results suggest that addition of rhG-CSF provides a more rapid response and that the three-drug combination therapy can be selected as empiric therapy for infections in neutropenic patients. |
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| Keywords: | Sulbactam/cefoperazone piperacillin rhG-CSF neutropenia pneumonia sepsis |
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