The clinical efficacy of combination therapy with amikacin, imipenem/cilastatin sodium and granulocyte colony-stimulating factor on infection in neutropenic patients with hematologic diseases

The clinical efficacy of combination therapy with amikacin (AMK), imipenem/cilastatin sodium (IPM/CS) and recombinant human granulocyte colony- stimulating factor (G-CSF) was evaluated in 32 neutropenic patients with hematological diseases. Clinical effectiveness was observed in 24 cases (including 3 cases of sepsis), an efficacy rate of 75.0%. The efficacy rate was 90% in the l0 patients with neutrophil counts less than 100/μl at the time of therapeutic evaluation. It was 81.1% (9/11) in patients whose neutrophil counts increased 20% or more during treatment and 66.7% (8/12) in patients whose neutrophil counts increased less than 20%; the difference in efficacy rates was not statistically significant. A clinical efficacy rate of 75.9% was observed in 29 neutropenic patients chosen according to the same criteria as those of the present study from among patients who were treated with AMK plus IPM/CS in a previous study (the historical controls . When the results in the historical control group were compared with those in the (G- CSF group, there was no significant difference in efficacy rate, profile of body temperature or duration of fever. The results suggest that combination therapy with AMK and IPM/CS is very effective in treating infections in neutropenic patients, with or without G-CSF.