ABSTRACT
The treatment of infectious complications in cancer patients has evolved as a consequence of the developments in the chemotherapy of cancer patients. In this prospective, randomized study, we compared imipenem-cilastatin and sulbactam-cefoperazone with amikacin in the empiric therapy of febrile neutropenic (< 1000/mm3) patients with liquids and solid tumours. Of 30 evaluable episodes, 15 were treated with imipenem-cilastatin and 15 were treated with sulbactam-cefoperazone plus amikacin. 73% of episodes were culture-positive: gram-positive pathogens accounted for 62% of the isolates. Bacteremia was the most frequent site of infection. The initial clinical response rate for both regimens was 60% (p > 0.05). No major adverse effects occurred. This study demonstrated that imipenem-cilastatin monotherapy and combination therapy of sulbactam-cefoperazone plus amikacin were equally effective empiric therapy for febrile granulocytopenic cancer patients.
Subject(s)
Drug Therapy, Combination/therapeutic use , Fever/drug therapy , Neoplasms/drug therapy , Neutropenia/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Amikacin/therapeutic use , Bacteremia/complications , Bacteremia/drug therapy , Cefoperazone/therapeutic use , Cilastatin/therapeutic use , Female , Fever/complications , Humans , Imipenem/therapeutic use , Male , Middle Aged , Neoplasms/complications , Neutropenia/complications , Prospective Studies , Sulbactam/therapeutic useABSTRACT
OBJECTIVE: The effects of dopamine infusion on portal blood flow were examined in 12 cirrhotic patients (seven men, five women) in a Child-B group. METHODS: Dopamine was administered as an intravenous infusion (2 micrograms kg-1 min-1). RESULTS: At 0, 30 and 60 min, portal blood flow, left ventricular systolic and diastolic functions were evaluated using the pulsed doppler method. No significant difference was found between heart rate, blood pressure and parameters demonstrating left ventricular systolic and diastolic functions before and after dopamine infusions. Portal blood flow decreased significantly at 30 and 60 min. Portal blood flow fell from 1802 +/- 88 to 1339 +/- 50 ml min-1 (P < 0.001) at 30 min and to 1121 +/- 60 ml min-1 (P < 0.001) at 60 min. CONCLUSION: The reducing effects of dopamine on portal blood flow in cirrhotic patients were demonstrated by the pulsed doppler method, which is a noninvasive test.
