T. Lamya et al., BENEFIT OF PROPHYLAXIS BY INTRAVENOUS SYSTEMIC VANCOMYCIN IN GRANULOCYTOPENIC PATIENTS - A PROSPECTIVE, RANDOMIZED TRIAL AMONG 59 PATIENTS, Acta haematologica, 90(3), 1993, pp. 109-113
We have tested the benefit of prophylaxis by intravenous systemic vanc
omycin among 59 neutropenic patients in a randomized trial. Vancomycin
was delivered on day zero of chemotherapy until the resolution of neu
tropenia in the prophylactic group (vanco+). Empiric antibiotic therap
y (piperacillin, ofloxacine) was identical for all patients. The numbe
r of days with fever > 38.5 degrees C was significantly higher in the
control (vanco-) group than in the vanco+ group (7.4 vs. 3.7, p < 0.02
). Zero gram-positive infections occurred in the vanco+ group versus 9
in the vanco- group (p < 0.002). The mean number of days of empiric a
ntibiotic therapy was reduced in the vanco+ group (11.3 vs. 16.3, p =
0.12). However, no benefit was noted between the two groups with regar
d to mortality or the severity of the infections. The selection of res
istant microorganisms after systemic treatment with vancomycin is of p
otential risk. Such a prophylactic antibiotic regimen does not seem to
be justified.