[Clinical evaluation of a combination therapy using cefmenoxime and cefsulodin on infections complicated by hematological disorders. Tohkai Research Group on Infections in Hematopoietic Disorders].
Infected patients with hematological disorders were treated with the combination of cefmenoxime (CMX) and cefsulodin (CFS). This therapy was done on 74 patients, of whom 38 (51%) had acute myelocytic leukemia, 14 (19%) malignant lymphoma, 7 (9%) acute lymphocytic leukemia, 5 aplastic anemia, 4 adult T cell leukemia, 4 chronic myelocytic leukemia, 1 multiple myeloma and 1 histiocytic medullary reticulosis. Complicated infections included 5 cases of septicemia, 41 cases of suspected septicemia, 19 cases of respiratory tract infection, 2 with anal abscess, 1 with urinary tract infection and others. The obtained results were as follows: Clinical effectiveness of the combination therapy was excellent in 17 cases (23.0%), good in 24 (32.4%) and poor in 33 (44.6%). Total clinical efficacy rate was 55.4%. Clinical efficacy rate was 40% against septicemias, 51.2% against suspected septicemias and 57.9% against respiratory tract infections. Causative pathogens were isolated in only 21 cases (28.4%): Gram-positive bacteria in 9 cases, Gram-negative bacteria in 11 and fungus in 1. About half of the Gram-negative bacteria belonged to Pseudomonas sp. The efficacy rate of this combination therapy against Gram-negative bacterial infections was 72.7% but the rate against Gram-positive bacterial infections were only 33.3%. Only in 1 case, this combination therapy was discontinued because of drug eruption. Abnormal laboratory findings were observed in 5 cases: Elevation of BUN in 3, GOT and GPT in 1 and prolongation of activated partial thromboplastin time in 1. In conclusion, this combination therapy of CMX and CFS is useful and safe against infections complicated by hematological disorders.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000741:Anemia, Aplastic / Q000150:complications; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy*; D015281:Cefmenoxime; D002439:Cefotaxime / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002441:Cefsulodin / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D007945:Leukemia, Lymphoid / Q000150:complications; D007951:Leukemia, Myeloid / Q000150:complications; D015470:Leukemia, Myeloid, Acute / Q000150:complications; D008223:Lymphoma / Q000150:complications; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes
D015281:Cefmenoxime; D002439:Cefotaxime; D002441:Cefsulodin