THE COMPARATIVE EVALUATION OF 4 ANTIBIOTIC REGIMENS IN FEBRILE NEUTROPENIC PATIENTS WITH HEMATOLOGIC MALIGNANCIES

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AHMADI F.; GHABOULI M.; KOSHYAR M.; KHALIGHI A.; ALAH YARI A.A.GH.; VAHEDIAN MOHAMMAD

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Journal: Medical Journal of Mashhad University of Medical Sciences Year:2005 | Volume:48 | Issue:88 Page(s): 131-136

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Title

THE COMPARATIVE EVALUATION OF 4 ANTIBIOTIC REGIMENS IN FEBRILE NEUTROPENIC PATIENTS WITH HEMATOLOGIC MALIGNANCIES

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Keywords

FEVER AND NEUTROGENAQ3

CEFTAZIDIMEQ4

AMIKACINQ3

CEFTRIAXONEQ4

CIPROFLOXACINQ3

IMIPENEMQ2

Abstract

Introduction: One of the fatal outcomes of hematologic cancers is bone marrow suppression & consequently the occurrence of fever & neutropenia. Even if the source of fever is unknown, according to the high risk of mortality during fever & neutropenia due to malignancy, empiric antibiotic therapy is unevitable. In this way, research for providing the best antibiotical regimen (according to different epidemiologies of microbial flora between countries, cities, hospitals & even various departments of it, beside the variations in races & genetics of world's population) by comparative study of 4 antibiotical regimens is the main goal of this research. Material and Methods: An interventional prospective study from September 2003 to October 2004 in departments of hematology-Oncology, infectious diseases & internal medicine emergencies, was performed on 103 cases who had hematologic cancers, fever, neutropenia (PMN<500) & without known source of infection. For these patients, antibiotical regimens of CEFTAZIDIME + AMIKACIN (regimen No.1), CIPROFLOXACIN + CEFTRIAXONE (regimen No.2), IMIPENEM (regimen No.3) & CEFTAZIDIME (regimen No.4) were used by systemic randomized sampling. Interruption or decline of fever beside the hemodynamic stability of patients in the first 72 hours of therapy with each of the regimens were the criteria of treatment's effectiveness & drugs' side effects were evaluated simultaneously. The information was collected by using of questionnaire & statistical analysis was performed by Chi- Square test according to SPSS. Results: Of 103 Patients who were studied, randomly 34 cases were treated with regimen NO.1 (20 positive responses & 14 negative), 27 0ases with regimen NO.2 (9 positive & 18 negative), 17 cases with regimen NO.3 (12 positive & 5 negative) & 25 cases with regimenNo.4 (16 positive & 9 negative). According to statistical analysis results regimen NO.2 in comparison to other regimens has a statistical meaningful difference, but other regimens, although has a superiority to regimen No.2, do not have any preference to each other. On the other hand ,there were only 11 cases of drug's adverse reactions in this study that are not analyzable(by statistics).Conclusion: In the epidemiologic status of Iran (& specially Mashad), similar to other parts of the world, the best treatment of fever & neutropenia without significant source of infection due to hematologic malignancies in high risk patients, is the usage of broad spectrum beta- lactam antibiotics with suitable coverage against gram negative bacteria, specially Pseudomonas. The usage of oral antibiotics (Ciprofloxacin) is not enough & reliable. On the other hand, treatment with combination regimens (Ceftazidime + AMIKACIN) or expensive drugs (Impienem) has no preference from the non expensive & simple ones (Ceftazidime). Correct monotherapy with CEFTAZIDIME not only reduces the side effects of combination regimens, but also is cost - benefit for patients & provides this possibility for greater number of patients to benefit from the usual facilities.

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APA: Copy

AHMADI, F., GHABOULI, M., KOSHYAR, M., KHALIGHI, A., ALAH YARI, A.A.GH., & VAHEDIAN, MOHAMMAD. (2005). THE COMPARATIVE EVALUATION OF 4 ANTIBIOTIC REGIMENS IN FEBRILE NEUTROPENIC PATIENTS WITH HEMATOLOGIC MALIGNANCIES. MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES, 48(88), 131-136. SID. https://sid.ir/paper/52255/en

Vancouver: Copy

AHMADI F., GHABOULI M., KOSHYAR M., KHALIGHI A., ALAH YARI A.A.GH., VAHEDIAN MOHAMMAD. THE COMPARATIVE EVALUATION OF 4 ANTIBIOTIC REGIMENS IN FEBRILE NEUTROPENIC PATIENTS WITH HEMATOLOGIC MALIGNANCIES. MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES[Internet]. 2005;48(88):131-136. Available from: https://sid.ir/paper/52255/en

IEEE: Copy

F. AHMADI, M. GHABOULI, M. KOSHYAR, A. KHALIGHI, A.A.GH. ALAH YARI, and MOHAMMAD VAHEDIAN, “THE COMPARATIVE EVALUATION OF 4 ANTIBIOTIC REGIMENS IN FEBRILE NEUTROPENIC PATIENTS WITH HEMATOLOGIC MALIGNANCIES,” MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES, vol. 48, no. 88, pp. 131–136, 2005, [Online]. Available: https://sid.ir/paper/52255/en

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