[Combined cefotaxime-amikacin treatment of infectious episodes in acute leukaemia patients with therapeutically-induced bone marrow aplasia (author's transl)].
In view of the clinical results obtained in severe septicaemia due to Gram-negative organisms, cefotaxime and amikacin combination was used in leukaemic patients with chemotherapeutic aplasia. 30 infectious episodes were treated in 22 cases of acute myeloid leukaemia, one case of acute flare-up in chronic leukaemia and 7 cases of acute lymphoid leukaemia. Cefotaxime was administered at daily doses of 100 mg/kg to the first 4 patients and of 60 mg/kg to the remaining 26 patients by infusion every 6 hours. Amikacin was administered at a daily dose of 15 mg/kg by the same route. 24 excellent results, 4 failures and 1 doubtful result were observed. Tolerance was very good. A new infection appeared in 9 patients during prolonged treatment (mean: 13,7 days). Cefotaxime appears to be a treatment of choice for infective conditions observed in chemotherapeutic aplastic leukaemia. A cure rate of 80% with amikacin combination can be obtained, but, in vivo, resistant pathogens (Streptococcus, group D) or poorly sensitive organisms (Pseudomonas aeruginosa + Bacteroides fragilis: 1 case) may be selected. Then, a new antibiotic treatment, based on accurate bacteriological results, could be given with success.
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000139:chemically induced / Q000150:complications*; D000583:Amikacin / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology; D002439:Cefotaxime; D002511:Cephalosporins / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D007612:Kanamycin / Q000031:analogs & derivatives*; D007938:Leukemia / Q000150:complications*; D008875:Middle Aged
D002511:Cephalosporins; D007612:Kanamycin; D000583:Amikacin; D002439:Cefotaxime
Traitement par une association céfotaxime-amikacine des épisodes infectieux des leucémies aiguës de l'adulte en aplasie thérapeutique.