ABSTRACT
The authors conducted a randomized trial on 16 patients to evaluate intestinal aerobic microfloral changes after prolonged oral treatment with bacampicillin (b.) (16 g/die) or amoxicillin (a.) (2 g/die). The analysis showed a quantitative reduction of isolates in 6 patients: 2 patients were treated with b. while 4 with a. (Odd ratio, O.R. = 3). Mean values of CFU presented as well a more evident reduction in a.-treated patients. From the qualitative point of view, bacteria modifications occurred in one patient treated with b. and 3 with a, (O.R. = 4.2). Bacterial changes, although not statistically significant, were thus greater in patients treated with a. than b.
Subject(s)
Amoxicillin/pharmacology , Ampicillin/analogs & derivatives , Intestines/microbiology , Adult , Aged , Ampicillin/pharmacology , Humans , Middle Aged , Time FactorsABSTRACT
Forty patients with leukemia or aplastic anemia were randomized to receive one of the following antibiotic regimens at the onset of fever during granulocytopenia: cefoperazone + amikacin (regimen A), cefoperazone + sisomicin (regimen B), cefotaxime + amikacin (regimen C), cefotaxime + sisomicin (regimen D). All patients were receiving gut decontamination at the time of randomization. Patients were monitored twice weekly with swabs and cultures for bacteria and fungi. Overall, there were 56 febrile episodes: 31 were proven bacterial, 3 were probable, and 16 were of unknown origin. Response rates were comparable in all 4 treatment regimens: 90%, 91%, 92% and 92%, respectively. Three patients died of bacterial infections (2 Gram+, 1 Gram-), one patient died with probable infection, 6 febrile episodes were related to fungal infection (Candida), and 2 patients died. The mortality rate was comparable in all groups. Two patients died of renal failure. Abnormalities in liver function tests were observed, but were without consequences. There were no statistical differences in renal-hepatic toxicity in the 4 arms.