Combined Efficacy of Fosfomycin and Sulbactam/Cefoperazone in Opportunistic Infections in Patients with Hematologic Disorders—A Randomized Comparative Study of Antibiotic Efficacy Based on the Order of Sequential Administration
التفاصيل البيبلوغرافية
العنوان:
Combined Efficacy of Fosfomycin and Sulbactam/Cefoperazone in Opportunistic Infections in Patients with Hematologic Disorders—A Randomized Comparative Study of Antibiotic Efficacy Based on the Order of Sequential Administration
We compared the clinical efficacy and safety of an antibiotic regimen based on the order of sequential administration in patients with hematologic disorders. In group A, 2 g of fosfomycin was injected intravenously, followed by an intravenous drip infusion of 1 to 2 g of sulbactam/cefoperazone 1 hour later. In group B, 1 to 2 g of sulbactam/cefoperazone was administered by intravenous drip infusion, followed 1 hour later by intravenous injection of 2 g of fosfomycin. The efficacy rates were 59% (45/76), and 43% (30/69) respectively. Group A showed a significantly higher efficacy rate than did group B (P=0.035, Wilcoxon rank-sum test). Group A also showed a higher efficacy rate than that found in our previously published studies that used single antibiotic administration. The clinical response for bacteremia was excellent and good in 5 patients of 8 patients, and the efficacy rates were 60% for sepsis and 43% for pneumonia. In group B, the clinical response for bacteriemia was excellent and good in 3 of 6 patients, and the efficacy rates were 42% for sepsis and 25% for pneumonia. The incidence of adverse reactions and abnormal laboratory findings in all patients evaluated for safety was 14% (12/85) in group A and 18% (14/76) in group B. Minimal difference was noted between the groups, and no serious cases were observed. These results suggest that fosfomycin administered first, followed by sulbactam/cefoperazone 1 hour later (as in group A) is an effective antibiotic regimen for severe opportunistic infections in patients with hematologic disorders.
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