A RANDOMIZED CLINICAL-TRIAL OF CEFTRIAXONE AND TEICOPLANIN VERSUS CEFTAZIDIME AND TEICOPLANIN AS ANTIBIOTIC-THERAPY IN FEBRILE NEUTROPENIC CANCER-PATIENTS AND BONE-MARROW TRANSPLANT RECIPIENTS

A prospective, randomized clinical trial comparing combination therapy with ceftriaxone and teicoplanin versus ceftazidime and teicoplanin i n the treatment of febrile episodes in neutropenic cancer patients and bone marrow transplant recipients was performed. One hundred and two patients were randomized, but two patients were considered unevaluable for efficacy, and three patients were withdrawn due to incorrect rand omization. Of the remaining 97 patients, infection resolved without mo dification of therapy in 31/49 (63%) patients treated with ceftriaxone /teicoplanin versus 27/48 (56%) patients treated with ceftazidime/teic oplanin (P=0.48). Of all 97 patients treated therapy was modified in 1 8/49 (36%) with ceftriaxone/teicoplanin and 21/48 (43%) with ceftazidi me/teicoplanin. Nineteen patients treated with ceftriaxone/teicoplanin received netilmicin and 21 patients treated with ceftazidime/teicopla nin also received netilmicin according to the study design (escalation therapy). When netilmicin was added infection resolved in 78% of pati ents treated with ceftriaxone/teicoplanin versus 84% of those treated with ceftazidime/teicoplanin. It was concluded that combination therap y with ceftriaxone/teicoplanin is an alternative to combination therap y with ceftazidime/teicoplanin, and has the advantage of once daily ad ministration.