AZTREONAM PLUS VANCOMYCIN VERSUS GENTAMICIN PLUS PIPERACILLIN AS EMPIRICAL THERAPY FOR THE TREATMENT OF FEVER IN NEUTROPENIC PATIENTS - A RANDOMIZED CONTROLLED-STUDY

The efficacy of aztreonam in combination with vancomycin was compared with that of gentamicin plus piperacillin as empirical antibiotic treatment for fever in 61 neutropenic patients. Aztreonam plus vancomycin was as effective, but no more effective, than gentamicin plus piperacillin. Aztreonam showed excellent clinical and in vitro efficacy against Gram-negative pathogens. Failure to respond to aztreonam plus vancomycin was, in most cases, due to presumed or documented fungal infection; by contrast, failure to respond to gentamicin plus piperacillin was frequently to be due to resistant or superadded infection with Gram-positive bacteria.