Author/Editor		Čižman, Milan; Gubina, Marija; Pokorn, Marko; Tomič, Viktorija
Title		Monoterapija ali kombinacija antibiotikov v zdravljenju febrilne nevtropenije
Translated title		Treatment of febrile neutropenia - monotherapy or combination therapy
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 35, št. Suppl 7
Publication year		1996
Volume		str. 71-85
Language		slo
Abstract		Infections are the main cause of morbidity and mortality in cancer patients with chemotherapy-associated neutropenia. Empirical antibiotic treatment should be given immediately when the first signs of infection appear in a neutropenic cancer patient. A combination of a betalactam antibiotic with antipseudomonal activity and aminoglycoside ?s usually used. With the use of combination therapy, a broader antimicrobial spectrum as well as a synergistic effect are achieved and the development of antimicrobial resistance is delayed or prevented. On the other hand, side-effects occur more frequently, the preparation and administration of drugs become more complex and the costs are higher with the use of antibiotic combinations. The efficacy of the combined use of antibiotics in treatment of febrile neutropenia ranges from 50 to 80 percent. New drugs characterized by a broad antimicrobial spectrum, bactericidal and antipseudomonal activity and lower toxicity have been introduced to the market in recent years. Compared to combined antibiotic treatment, monotherapy Is simpler, safer and cheaper. A review clinical experience up to the present with the use of different antibiotic combinations as well as monotherapy using ceftazidime, cefpirome, imipenem/cilastatin, meropenem, piperacilin/tazobactam and quinolones is presented. Bacteria isolated from blood cultures of patients from three hematooncological departments of the University Medical Center Ljubljana in the period from 1994 to 1995 were analyzed. Their antibiotic sensitivity was studied as well. Atotal of 297 bacteria and fungi were isolated during this period. Among bacteria, two-thirds were Gram-positive. Coagulase-negative staphylococci (CNS) were the most frequent (111/297) Gram-positive isolates, followed by S. aureus (35/297) and S. viridans (14/297). Among Gram-negative organisms, E coli (37/297), Klebsiella (17/297) and P. aeruginosa (15/297) predominate. Abstract truncated at 2000 characters.
Descriptors		NEUTROPENIA ANTIBIOTICS BACTERIAL INFECTIONS FEVER