Abstract
This study compared the efficacy of therapy with the double beta-lactam combination of ceftazidime plus piperacillin with that of single-agent therapy with ceftazidime, piperacillin, or amikacin alone and with that of two aminoglycoside-beta-lactam combinations against Pseudomonas aeruginosa peritonitis and bacteremia in neutropenic rats. Rats made severely granulocytopenic with cyclophosphamide became bacteremic secondary to peritonitis which was induced by intraperitoneal challenge with P. aeruginosa. Antibiotic therapy with single agents (amikacin, 20 mg/kg of body weight, intramuscularly; ceftazidime, 20 mg/kg of body weight, subcutaneously; piperacillin, 200 mg/kg of body weight, intramuscularly) or with the various combinations of agents was begun 2 h after bacterial challenge and was continued every 6 to 8 h for 62 h. Therapeutic efficacy was judged on the basis of survival 72 h after bacterial challenge, rate of mortality, incidence of bacteremia, and the emergence of resistant organisms. Based on these criteria, therapy with the double beta-lactam combination had no advantage over single-agent therapy and was in all cases clearly inferior to beta-lactam-aminoglycoside combinations.
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Selected References
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- Bodey G. P., Bolivar R., Fainstein V., Jadeja L. Infections caused by Pseudomonas aeruginosa. Rev Infect Dis. 1983 Mar-Apr;5(2):279–313. doi: 10.1093/clinids/5.2.279. [DOI] [PubMed] [Google Scholar]
- Johnson D. E., Calia F. M., Snyder M. J., Warren J. W., Schimpff S. C. Imipenem therapy of Pseudomonas aeruginosa bacteraemia in neutropenic rats. J Antimicrob Chemother. 1983 Dec;12 (Suppl 500):89–96. doi: 10.1093/jac/12.suppl_d.89. [DOI] [PubMed] [Google Scholar]
- Kluge R. M., Standiford H. C., Tatem B., Young V. M., Schimpff S. C., Greene W. H., Calia F. M., Hornick R. B. The carbenicillin-gentamicin combination against Pseudomonas aeruginosa. Correlation of effect with gentamicin sensitivity. Ann Intern Med. 1974 Nov;81(5):584–587. doi: 10.7326/0003-4819-81-5-584. [DOI] [PubMed] [Google Scholar]
- Love L. J., Schimpff S. C., Hahn D. M., Young V. M., Standiford H. C., Bender J. F., Fortner C. L., Wiernik P. H. Randomized trial of empiric antibiotic therapy with ticarcillin in combination with gentamicin, amikacin or netilmicin in febrile patients with granulocytopenia and cancer. Am J Med. 1979 Apr;66(4):603–610. doi: 10.1016/0002-9343(79)91170-7. [DOI] [PubMed] [Google Scholar]
- Lumish R. M., Norden C. W. Therapy of neutropenic rats infected with Pseudomonas aeruginosa. J Infect Dis. 1976 May;133(5):538–547. doi: 10.1093/infdis/133.5.538. [DOI] [PubMed] [Google Scholar]
- Neu H. C., Labthavikul P. Antibacterial activity and beta-lactamase stability of ceftazidime, an aminothiazolyl cephalosporin potentially active against Pseudomonas aeruginosa. Antimicrob Agents Chemother. 1982 Jan;21(1):11–18. doi: 10.1128/aac.21.1.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Scott R. E., Robson H. G. Synergistic activity of carbenicillin and gentamicin in experimental Pseudomonas bacteremia in neutropenic rats. Antimicrob Agents Chemother. 1976 Oct;10(4):646–651. doi: 10.1128/aac.10.4.646. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Winston D. J., Barnes R. C., Ho W. G., Young L. S., Champlin R. E., Gale R. P. Moxalactam plus piperacillin versus moxalactam plus amikacin in febrile granulocytopenic patients. Am J Med. 1984 Sep;77(3):442–450. doi: 10.1016/0002-9343(84)90100-1. [DOI] [PubMed] [Google Scholar]
- Winston D. J., Ho W. G., Young L. S., Hewitt W. L., Gale R. P. Piperacillin plus amikacin therapy v carbenicillin plus amikacin therapy in febrile, granulocytopenic patients. Arch Intern Med. 1982 Sep;142(9):1663–1667. [PubMed] [Google Scholar]
