COMETTA A, KERN WV, DEBOCK R, PAESMANS M, VANDENBERGH M, CROKAERT F, ENGELHARD D, MARCHETTI O, AKAN H, BASSARIS H, KORTEN V, VISCOLI C, GLAUSER MP; THE INTERNATIONAL ANTIMICROBIAL THERAPY GROUP OF THE EORTC; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. L-774.
CHUV, Lausanne, Switzerland
The addition of a glycopeptide in NCP with persistent fever after 48h of empirical antibiotic therapy has become a common practice. However, the benefit of this procedure has never been proved. Of a total of 763 eligible febrile NCP enrolled in a noncomparative trial of PT monotherapy (4.5g q6h), response to PT monotherapy was assessed in 598 NCP and the success rate was 52% (CI 95%: 48-56%). The enrolled NCP with unexplained fever (FUO), clinically documented infections (CDI) and PT-susceptible Gram + bacteremias (G+ Bact.) were randomized to receive Van (1g q12h) or Pla provided that they had a persistent fever and a neutropenia (<500/mm[3]) after 48-60 h of PT monotherapy. Defervescence was defined as a period of 3 complete consecutive days with a temperature < 38 degrees. Among 165 randomized eligible NCP, the median duration of neutropenia was 14 days; FUO accounted for 72% in Van and 73% in Pla, CDI for 16 and 17% and G+ Bact.for 12 and 10%, respectively. CONCLUSION: NI The present study does not support the empirical addition of Van in persistently febrile NCP not responding to initial broad-spectrum empirical antibiotic therapy. Glycopeptides can be withheld safely in such NCP and can be restricted to well defined indications in order to prevent the emergence of resistance.
Publication Types:
Keywords:
- Blindness
- Body Temperature
- Clinical Trials as Topic
- Double-Blind Method
- Fever
- Fever of Unknown Origin
- Humans
- Infection
- Neutropenia
- Penicillanic Acid
- Piperacillin
- Placebos
- Vancomycin
- tazobactam
Other ID:
UI: 102269494
From Meeting Abstracts