title: Adverse reactions to prolonged treatment with high doses of carbenicillin and ureidopenicillins.
abstract: Charts were reviewed for 63 patients whose chronic pseudomonas osteomyelitis was treated with high doses of extended-spectrum penicillins for prolonged periods. The incidence of untoward drug reactions was significantly higher than expected. Carbenicillin evoked adverse reactions in 22.8% of patients. However, most of these reactions were mild, and a change of drug was required in only 5.7% of cases. No adverse drug reactions were observed with cumulative doses of less than 750 g. In contrast to carbenicillin, the ureidopenicillins were associated with adverse reactions in 67.7% of patients; most reactions were moderate to severe in intensity; a cumulative dose of greater than 250 g produced adverse reactions; and discontinuation or change of therapy was required in 51.6% of cases. The main adverse reactions to both carbenicillin and the ureidopenicillins included rash, drug fever, leukopenia, eosinophilia, thrombocytopenia, and hepatic damage.
authors.affiliation: Department of Medicine A, Meir Hospital, Kfar-Saba, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Lang
authors.forename: M
authors.initials: M
authors.lastname: Lishner
authors.forename: M
authors.initials: M
authors.lastname: Ravid
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001390:Azlocillin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002228:Carbenicillin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004802:Eosinophilia / Q000139:chemically induced; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008099:Liver / Q000187:drug effects; D008297:Male; D008802:Mezlocillin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy; D010878:Piperacillin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011552:Pseudomonas Infections / Q000188:drug therapy*; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000139:chemically induced
chemical_list: D002228:Carbenicillin; D001390:Azlocillin; D008802:Mezlocillin; D010878:Piperacillin