Timentin in combination with tobramycin as empirical therapy in febrile neutropenic patients with haematological malignancies.
Timentin (5.2 g tds) and tobramycin (40 mg tds) were administered to 51 patients (22 male, 29 female, age range 17-72, mean age 40.4) with acute leukaemia, chronic myeloid leukaemia in blastic crisis, severe aplastic anaemia and acute agranulocytopenia. All patients had neutropenia (PMN less than 1000/mm3) and fever (greater than 38 degrees C). Febrile episodes consisted of 22 proved septicaemias due to Gram-positive organisms (Staphylococcus aureus, S. epidermidis, enterococcus) in 11 cases and to Gram-negative organisms (Escherichia coli, Pseudomonas aeruginosa, Alkaligenes faecalis, Serratia marcescens, Klebsiella pneumoniae) in 10 cases. One patient had a polymicrobial infection (P. aeruginosa, S. aureus, non-haemolytic streptococcus). Twenty-nine infections were diagnosed only clinically. The mean duration of treatment was 11.1 days (range 4-20 days). Eighty-seven per cent of evaluable febrile episodes improved. Among 11 infections due to Gram-positive cocci, eight (72%) resolved, and in nine (90%) of ten cases due to Gram-negative bacilli success was obtained. The polymicrobial infection also resolved. In only four patients were mild side effects seen, e.g. exanthema, pruritus, phlebitis: renal toxicity was not observed. These data suggest that the combination of Timentin and tobramycin is an effective and safe empirical antibiotic regimen in febrile neutropenic patients.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000150:complications; D000741:Anemia, Aplastic / Q000150:complications; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D002969:Clavulanic Acids / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004338:Drug Combinations / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007938:Leukemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology; D010403:Penicillin Resistance; D010406:Penicillins / Q000627:therapeutic use*; D013982:Ticarcillin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D014031:Tobramycin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
D002969:Clavulanic Acids; D004338:Drug Combinations; D010406:Penicillins; C043215:ticarcillin-clavulanic acid; D013982:Ticarcillin; D014031:Tobramycin