Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Raad, I.
Right arrow Articles by Sukumaran, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Raad, I.
Right arrow Articles by Sukumaran, A.
Related Collections
Right arrow Other Medical
Annals of Surgical Oncology 8:179-186 (2001)
© 2001 Society of Surgical Oncology

ORIGINAL ARTICLES

Treatment of Nosocomial Postoperative Pneumonia in Cancer Patients: A Prospective Randomized Study

I. Raad, MD, R. Hachem, MD, H. Hanna, MD, D. Abi-Said, PhD, C. Bivins, RN, G. Walsh, MD, J. Thornby, PhD, E. Whimbey, MD, A. Huaringa, MD and A. Sukumaran, MD

From the Department of Internal Medicine Specialties Section of Infection Control (IR) and Section of Infectious Diseases (RH, HH, DA-S, EW), the Department of Leukemia (CB), the Department of Cardio-Thoracic Surgery (GW), the Department of Internal Medicine Specialties, Section of Pulmonary Medicine (AH), and the Department of Anesthesiology and Critical Care (AS), The University of Texas M. D. Anderson Cancer Center, Houston, Texas; and Department of Family and Community Medicine (JT), Baylor College of Medicine, Houston, Texas.

Correspondence: Address correspondence and reprint requests to: Issam Raad, MD, FACP, Section of Infection Control (Box 47), The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030; Fax: 713-792-8233; E-mail: iraad{at}mdanderson.org

Background: Nosocomial pneumonia continues to be associated with high morbidity and mortality in cancer patients.

Methods: In an attempt to find an optimal treatment for this infection, nonneutropenic cancer patients with postoperative nosocomial pneumonia were randomized to receive either piperacillin/tazobactam (P/T) 4.5 g IV every 6 hours (30 patients) or clindamycin (Cl) 900 mg plus aztreonam (Az) 2 g IV every 8 hours (22 patients). Amikacin 500 mg IV every 12 hours was given to all patients for the first 48 hours.

Results: The two groups were comparable for the characteristics of pneumonia that included Gram-negative etiology and duration of intubation. Response rates were 83% for patients who received P/T and 86% for those who received Cl/Az (P > .99). There were no serious adverse events; however, at our center the cost of the P/T regimen was $73.86 compared with $99.15 for the Cl/Az regimen.

Conclusions: The two regimens had comparable high efficacy, and P/T had a slight cost advantage. Either of these antibiotic regimens combined with an aminoglycoside could lead to favorable outcome in cancer patients at high risk for nosocomial pneumonia.

Key Words: Nosocomial • Pneumonia • Antibiotics • Cancer • Postoperative






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2001 by the Society of Surgical Oncology.