Skip to main content
NCBI home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1984 Sep;26(3):295–299. doi: 10.1128/aac.26.3.295

Piperacillin plus vancomycin in the therapy of febrile episodes in cancer patients.

L Jadeja, R Bolivar, V Fainstein, M Keating, K McCredie, M Hay, G P Bodey
PMCID: PMC176155  PMID: 6508260

Abstract

Piperacillin and vancomycin were used as initial empirical therapy for 211 febrile episodes in cancer patients. The response rate in 95 episodes of documented infection was 72%. The response of bacteremias, soft tissue infections, and pneumonias was 78, 71, and 38%, respectively. The response in infections caused by gram-negative organisms was 73%. Only 6 of 10 Pseudomonas aeruginosa infections responded to therapy, although the organisms were sensitive in vitro to piperacillin. Of 14 infections caused by gram-positive organisms, 12 responded to this combination. No major side effects were observed with this regimen. Although the overall response rate with this antibiotic combination was comparable with other regimens used for neutropenic patients, superior results might be obtained by combining piperacillin with an extended-spectrum cephalosporin or an aminoglycoside.

Full text

PDF
295

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bodey G. P., Ketchel S. J., Rodriguez V. A randomized study of carbenicillin plus cefamandole or tobramycin in the treatment of febrile episodes in cancer patients. Am J Med. 1979 Oct;67(4):608–616. doi: 10.1016/0002-9343(79)90242-0. [DOI] [PubMed] [Google Scholar]
  2. Bodey G. P., Le Blanc B. Piperacillin: in vitro evaluation. Antimicrob Agents Chemother. 1978 Jul;14(1):78–87. doi: 10.1128/aac.14.1.78. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bodey G. P., Whitecar J. P., Jr, Middleman E., Rodriguez V. Carbenicillin therapy for pseudomonas infections. JAMA. 1971 Oct 4;218(1):62–66. [PubMed] [Google Scholar]
  4. Eliopoulos G. M., Moellering R. C., Jr Azlocillin, mezlocillin, and piperacillin: new broad-spectrum penicillins. Ann Intern Med. 1982 Nov;97(5):755–760. doi: 10.7326/0003-4819-97-5-755. [DOI] [PubMed] [Google Scholar]
  5. Gootz T. D., Sanders C. C., Sanders W. E., Jr In vitro activity of furazlocillin (Bay k 4999) compared with those of mezlocillin, piperacillin, and standard beta-lactam antibiotics. Antimicrob Agents Chemother. 1979 Jun;15(6):783–791. doi: 10.1128/aac.15.6.783. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Gribble M. J., Chow A. W., Naiman S. C., Smith J. A., Bowie W. R., Sacks S. L., Grossman L., Buskard N., Growe G. H., Plenderleith L. H. Prospective randomized trial of piperacillin monotherapy versus carboxypenicillin-aminoglycoside combination regimens in the empirical treatment of serious bacterial infections. Antimicrob Agents Chemother. 1983 Sep;24(3):388–393. doi: 10.1128/aac.24.3.388. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Keating M. J., Lawson R., Grose W., Bodey G. P. Combination therapy with ticarcillin and sulfamethoxazole-trimethoprim for infections in patients with cancer. Arch Intern Med. 1981 Jun;141(7):926–930. [PubMed] [Google Scholar]
  8. Valdivieso M., Gil-extremera B., Zornoza J., Rodriquez V., Bodey G. P. Gram-negative bacillary pneumonia in the compromised host. Medicine (Baltimore) 1977 May;56(3):241–254. doi: 10.1097/00005792-197705000-00005. [DOI] [PubMed] [Google Scholar]
  9. Valdivieso M., Horikoshi N., Rodriguez V., Bodey G. P. Therapeutic trials with tobramycin. Am J Med Sci. 1974 Sep;268(3):149–156. doi: 10.1097/00000441-197409000-00003. [DOI] [PubMed] [Google Scholar]
  10. Verbist L. In vitro activity of piperacillin, a new semisynthetic penicillin with an unusually broad spectrum of activity. Antimicrob Agents Chemother. 1978 Mar;13(3):349–357. doi: 10.1128/aac.13.3.349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Wade J. C., Schimpff S. C., Newman K. A., Fortner C. L., Standiford H. C., Wiernik P. H. Piperacillin or ticarcillin plus amikacin. A double-blind prospective comparison of empiric antibiotic therapy for febrile granulocytopenic cancer patients. Am J Med. 1981 Dec;71(6):983–990. doi: 10.1016/0002-9343(81)90324-7. [DOI] [PubMed] [Google Scholar]
  12. Wade J. C., Schimpff S. C., Newman K. A., Wiernik P. H. Staphylococcus epidermidis: an increasing cause of infection in patients with granulocytopenia. Ann Intern Med. 1982 Oct;97(4):503–508. doi: 10.7326/0003-4819-97-4-503. [DOI] [PubMed] [Google Scholar]
  13. White A. R., Comber K. R., Sutherland R. Comparative bactericidal effects of azlocillin and ticarcillin against Pseudomonas aeruginosa. Antimicrob Agents Chemother. 1980 Jul;18(1):182–189. doi: 10.1128/aac.18.1.182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Winston D. J., Wang D., Young L. S., Martin W. J., Hewitt W. L. In vitro studies of piperacilin, a new semisynthetic penicillin. Antimicrob Agents Chemother. 1978 Jun;13(6):944–950. doi: 10.1128/aac.13.6.944. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES