MRSA sepsis in patients with hematological malignancies: Importance of early administration of intravenous vancomycin

Minoru Yoshida, Mami Ito, Toru Izumi, Hirokazu Kurata, Saburo Tsunoda, Yoshiaki Hosino, Seiji Okada, Junichi Tsunoda, Shigehiko Imagawa, Toshiyuki Suzuki, Norio Komatsu, Kazuo Muroi, Kiyohiko Hatake, Akiyoshi Miwa, Toshio Suda, Shinobu Sakamoto, Yasusada Miura, Mutsumu Hayashi

Research output: Contribution to journalArticle

Abstract

From 1985 to 1991, MRSA sepsis was identified in 18 patients with hematological malignancies. The mortality rate was 55.6% (10/18), and the presence of DIC was significantly associated with high mortality (p=0.02). In addition to the use of standard empiric therapy, vancomycin was intravenously administered to 10 patients. The daily dose of 1.5 g was divided into 3 times, and was administered in 60-minute infusions. Patients 60 years of age or older received a daily dose of 1.0 g. The prognosis of 6 patients who received vancomycin within 4 days of the onset of sepsis was significantly better than that of 4 patients who received it 4 or more days after the onset of sepsis and that of 8 patients who did not receive it (mortality was 1/6 vs. 9/12; p=0.04). As for the side effects, liver dysfunction was observed in 5 patients and renal dysfunction was observed in 3 patients. The administration of VCM was discontinued in one of the former and was continued at a reduced dose in one of the latter. Because of the severity of the illness and the lack of effective drugs, we concluded that vancomycin is a highly useful drug for the treatment of MRSA sepsis in patients with hematological malignancies.

Original languageEnglish
Pages (from-to)976-980
Number of pages5
JournalChemotherapy
Volume42
Issue number8
DOIs
Publication statusPublished - 1994 Jan 1
Externally publishedYes

Keywords

  • MRSA
  • hematological malignancies
  • sepsis
  • vancomycin

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases
  • Pharmacology
  • Drug Discovery
  • Oncology

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  • Cite this

    Yoshida, M., Ito, M., Izumi, T., Kurata, H., Tsunoda, S., Hosino, Y., Okada, S., Tsunoda, J., Imagawa, S., Suzuki, T., Komatsu, N., Muroi, K., Hatake, K., Miwa, A., Suda, T., Sakamoto, S., Miura, Y., & Hayashi, M. (1994). MRSA sepsis in patients with hematological malignancies: Importance of early administration of intravenous vancomycin. Chemotherapy, 42(8), 976-980. https://doi.org/10.11250/chemotherapy1953.42.976