Initial antibacterial therapy with imipenem/cilastatin sodium for infections in granulocytopenic patients with hematological diseases

S. Misawa, S. Tsuda, M. Taniwaki, S. Horiike, Y. Ariyama, K. Hirakawa, Y. Ueda, H. Kaneko, M. Nakao, K. Kashima, H. Nakagawa, H. Fujii, Y. Ohkawara, Hiroyuki Nakai, S. Yokota

Research output: Contribution to journalArticle

Abstract

Imipenem/cilastatin sodium (IPM/CS) was used as an initial antibacterial therapy for infections in granulocytopenic patients undergoing ciprofloxacin (CPFX) prophylaxis. Oral CPFX was started at 600 mg daily when peripheral blood granulocytes dropped below 500/μl. As soon as febrile episodes developed, IPM/CS 1 gx2/d d.i.v. was instituted. As underlying diseases, 28 patients had acute leukemia, myeloblastic or lymphoblastic, 1 chronic melogenous leukemia in blast crisis, 3 myelodysplastic syndrome, and 15 malignant lymphoma. Bacterial infections diagnosed were sepsis in 8 patients, suspected sepsis in 36, and other infections in 3. The overall response rate to this treatment was 80.9%, and those for sepsis, suspected sepsis, and other infectious diseases were 62.5%, 83.3%, and 100%, respectively. This regimen was also effective in 76.9% (10/13) of patients whose granulocyte count remained below 100/μl throughout the course of IPM/CS therapy. The causative organism was identified in 10 infections including 8 sepsis cases; 8 organisms were gram-positive bacteria, and 7 were susceptible. There was no difference in effectiveness between those patients who were receiving G-CSF and those who were not (20/27, 74.1% vs 18/20, 90.0%). As adverse reactions, gastrointestinal tract symptoms such as nausea, vomiting, or anorexia were observed in 7 patients (11.7%), liver function disturbance in 3 (5.09;), and proteinuria in 1 (1.7%), among 60 evaluable episodes. Thus, initial antibacterial therapy with IPM/CS following oral prophylactic use of CPFX is an effective and safe regimen for the treatment of febrile granulocytopenic infections in patients with hematological malignancies.

Original languageEnglish (US)
Pages (from-to)1062-1068
Number of pages7
JournalJapanese Journal of Chemotherapy
Volume43
Issue number11
StatePublished - 1995
Externally publishedYes

Fingerprint

Cilastatin
Hematologic Diseases
Sepsis
Infection
Ciprofloxacin
Granulocytes
Therapeutics
Fever
Blast Crisis
Myelodysplastic Syndromes
Anorexia
Gram-Positive Bacteria
Granulocyte Colony-Stimulating Factor
Hematologic Neoplasms
imipenem drug combination cilastatin
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Proteinuria
Bacterial Infections
Acute Myeloid Leukemia
Nausea

Keywords

  • Cancer
  • ciprofloxacin
  • Granulocytopenia
  • imipenem/cilastatin

ASJC Scopus subject areas

  • Pharmacology

Cite this

Misawa, S., Tsuda, S., Taniwaki, M., Horiike, S., Ariyama, Y., Hirakawa, K., ... Yokota, S. (1995). Initial antibacterial therapy with imipenem/cilastatin sodium for infections in granulocytopenic patients with hematological diseases. Japanese Journal of Chemotherapy, 43(11), 1062-1068.

Initial antibacterial therapy with imipenem/cilastatin sodium for infections in granulocytopenic patients with hematological diseases. / Misawa, S.; Tsuda, S.; Taniwaki, M.; Horiike, S.; Ariyama, Y.; Hirakawa, K.; Ueda, Y.; Kaneko, H.; Nakao, M.; Kashima, K.; Nakagawa, H.; Fujii, H.; Ohkawara, Y.; Nakai, Hiroyuki; Yokota, S.

In: Japanese Journal of Chemotherapy, Vol. 43, No. 11, 1995, p. 1062-1068.

Research output: Contribution to journalArticle

Misawa, S, Tsuda, S, Taniwaki, M, Horiike, S, Ariyama, Y, Hirakawa, K, Ueda, Y, Kaneko, H, Nakao, M, Kashima, K, Nakagawa, H, Fujii, H, Ohkawara, Y, Nakai, H & Yokota, S 1995, 'Initial antibacterial therapy with imipenem/cilastatin sodium for infections in granulocytopenic patients with hematological diseases', Japanese Journal of Chemotherapy, vol. 43, no. 11, pp. 1062-1068.
Misawa, S. ; Tsuda, S. ; Taniwaki, M. ; Horiike, S. ; Ariyama, Y. ; Hirakawa, K. ; Ueda, Y. ; Kaneko, H. ; Nakao, M. ; Kashima, K. ; Nakagawa, H. ; Fujii, H. ; Ohkawara, Y. ; Nakai, Hiroyuki ; Yokota, S. / Initial antibacterial therapy with imipenem/cilastatin sodium for infections in granulocytopenic patients with hematological diseases. In: Japanese Journal of Chemotherapy. 1995 ; Vol. 43, No. 11. pp. 1062-1068.
@article{3cb37a3eba944e23b09b668c70df2d8b,
title = "Initial antibacterial therapy with imipenem/cilastatin sodium for infections in granulocytopenic patients with hematological diseases",
abstract = "Imipenem/cilastatin sodium (IPM/CS) was used as an initial antibacterial therapy for infections in granulocytopenic patients undergoing ciprofloxacin (CPFX) prophylaxis. Oral CPFX was started at 600 mg daily when peripheral blood granulocytes dropped below 500/μl. As soon as febrile episodes developed, IPM/CS 1 gx2/d d.i.v. was instituted. As underlying diseases, 28 patients had acute leukemia, myeloblastic or lymphoblastic, 1 chronic melogenous leukemia in blast crisis, 3 myelodysplastic syndrome, and 15 malignant lymphoma. Bacterial infections diagnosed were sepsis in 8 patients, suspected sepsis in 36, and other infections in 3. The overall response rate to this treatment was 80.9{\%}, and those for sepsis, suspected sepsis, and other infectious diseases were 62.5{\%}, 83.3{\%}, and 100{\%}, respectively. This regimen was also effective in 76.9{\%} (10/13) of patients whose granulocyte count remained below 100/μl throughout the course of IPM/CS therapy. The causative organism was identified in 10 infections including 8 sepsis cases; 8 organisms were gram-positive bacteria, and 7 were susceptible. There was no difference in effectiveness between those patients who were receiving G-CSF and those who were not (20/27, 74.1{\%} vs 18/20, 90.0{\%}). As adverse reactions, gastrointestinal tract symptoms such as nausea, vomiting, or anorexia were observed in 7 patients (11.7{\%}), liver function disturbance in 3 (5.09;), and proteinuria in 1 (1.7{\%}), among 60 evaluable episodes. Thus, initial antibacterial therapy with IPM/CS following oral prophylactic use of CPFX is an effective and safe regimen for the treatment of febrile granulocytopenic infections in patients with hematological malignancies.",
keywords = "Cancer, ciprofloxacin, Granulocytopenia, imipenem/cilastatin",
author = "S. Misawa and S. Tsuda and M. Taniwaki and S. Horiike and Y. Ariyama and K. Hirakawa and Y. Ueda and H. Kaneko and M. Nakao and K. Kashima and H. Nakagawa and H. Fujii and Y. Ohkawara and Hiroyuki Nakai and S. Yokota",
year = "1995",
language = "English (US)",
volume = "43",
pages = "1062--1068",
journal = "Japanese Journal of Chemotherapy",
issn = "1340-7007",
publisher = "Japan Society of Chemotherapy",
number = "11",

}

TY - JOUR

T1 - Initial antibacterial therapy with imipenem/cilastatin sodium for infections in granulocytopenic patients with hematological diseases

AU - Misawa, S.

AU - Tsuda, S.

AU - Taniwaki, M.

AU - Horiike, S.

AU - Ariyama, Y.

AU - Hirakawa, K.

AU - Ueda, Y.

AU - Kaneko, H.

AU - Nakao, M.

AU - Kashima, K.

AU - Nakagawa, H.

AU - Fujii, H.

AU - Ohkawara, Y.

AU - Nakai, Hiroyuki

AU - Yokota, S.

PY - 1995

Y1 - 1995

N2 - Imipenem/cilastatin sodium (IPM/CS) was used as an initial antibacterial therapy for infections in granulocytopenic patients undergoing ciprofloxacin (CPFX) prophylaxis. Oral CPFX was started at 600 mg daily when peripheral blood granulocytes dropped below 500/μl. As soon as febrile episodes developed, IPM/CS 1 gx2/d d.i.v. was instituted. As underlying diseases, 28 patients had acute leukemia, myeloblastic or lymphoblastic, 1 chronic melogenous leukemia in blast crisis, 3 myelodysplastic syndrome, and 15 malignant lymphoma. Bacterial infections diagnosed were sepsis in 8 patients, suspected sepsis in 36, and other infections in 3. The overall response rate to this treatment was 80.9%, and those for sepsis, suspected sepsis, and other infectious diseases were 62.5%, 83.3%, and 100%, respectively. This regimen was also effective in 76.9% (10/13) of patients whose granulocyte count remained below 100/μl throughout the course of IPM/CS therapy. The causative organism was identified in 10 infections including 8 sepsis cases; 8 organisms were gram-positive bacteria, and 7 were susceptible. There was no difference in effectiveness between those patients who were receiving G-CSF and those who were not (20/27, 74.1% vs 18/20, 90.0%). As adverse reactions, gastrointestinal tract symptoms such as nausea, vomiting, or anorexia were observed in 7 patients (11.7%), liver function disturbance in 3 (5.09;), and proteinuria in 1 (1.7%), among 60 evaluable episodes. Thus, initial antibacterial therapy with IPM/CS following oral prophylactic use of CPFX is an effective and safe regimen for the treatment of febrile granulocytopenic infections in patients with hematological malignancies.

AB - Imipenem/cilastatin sodium (IPM/CS) was used as an initial antibacterial therapy for infections in granulocytopenic patients undergoing ciprofloxacin (CPFX) prophylaxis. Oral CPFX was started at 600 mg daily when peripheral blood granulocytes dropped below 500/μl. As soon as febrile episodes developed, IPM/CS 1 gx2/d d.i.v. was instituted. As underlying diseases, 28 patients had acute leukemia, myeloblastic or lymphoblastic, 1 chronic melogenous leukemia in blast crisis, 3 myelodysplastic syndrome, and 15 malignant lymphoma. Bacterial infections diagnosed were sepsis in 8 patients, suspected sepsis in 36, and other infections in 3. The overall response rate to this treatment was 80.9%, and those for sepsis, suspected sepsis, and other infectious diseases were 62.5%, 83.3%, and 100%, respectively. This regimen was also effective in 76.9% (10/13) of patients whose granulocyte count remained below 100/μl throughout the course of IPM/CS therapy. The causative organism was identified in 10 infections including 8 sepsis cases; 8 organisms were gram-positive bacteria, and 7 were susceptible. There was no difference in effectiveness between those patients who were receiving G-CSF and those who were not (20/27, 74.1% vs 18/20, 90.0%). As adverse reactions, gastrointestinal tract symptoms such as nausea, vomiting, or anorexia were observed in 7 patients (11.7%), liver function disturbance in 3 (5.09;), and proteinuria in 1 (1.7%), among 60 evaluable episodes. Thus, initial antibacterial therapy with IPM/CS following oral prophylactic use of CPFX is an effective and safe regimen for the treatment of febrile granulocytopenic infections in patients with hematological malignancies.

KW - Cancer

KW - ciprofloxacin

KW - Granulocytopenia

KW - imipenem/cilastatin

UR - http://www.scopus.com/inward/record.url?scp=0029560954&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029560954&partnerID=8YFLogxK

M3 - Article

VL - 43

SP - 1062

EP - 1068

JO - Japanese Journal of Chemotherapy

JF - Japanese Journal of Chemotherapy

SN - 1340-7007

IS - 11

ER -