title: [Sulbenicillin and amikacin for febrile patients with cancer--with special reference to granulocytopenia].
abstract: Between March 1978 and March 1983 ninety-four episodes of fever in 56 mainly granulocytopenic patients with cancer were treated empirically with a combination of sulbenicillin (5.0 g, every 6 hours) and amikacin (200 mg, every 6 hours) in Saitama Cancer Center. Profound granulocytopenia at the beginning of treatment (less than 100/mm3 of granulocytes) was present in 66% of the patients. Oral absorbable or nonabsorbable antibiotics were used in 59 febrile episodes. WBC transfusion was not given. The response rate for all documented infections was 75%, including 10 of 13 (77%) of bacteremias. The majority of infections with identified organisms were caused by aerobic gram-negative bacilli: the major gram-negative pathogens being Ps. aeruginosa (11 cases), Klebsiella spp. (7 cases), E. coli (7 cases) and Enterobacter spp. (7 cases). The response rate of gram-negative bacilliary infections was 74%. Pneumonia responded less satisfactorily than all other types of infection with the response rate of 20%. The response rate of 69% for profound persistent granulocytopenia (less than 100/mm3 of granulocytes without a rise during therapy) is higher than that of any other reports. The most common adverse effect was hepatotoxicity (19%), whereas oliguria or anuria occurred in two patients, by which they eventually expired.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000188:drug therapy* / Q000209:etiology; D000583:Amikacin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007612:Kanamycin / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010400:Penicillin G / Q000031:analogs & derivatives*; D013408:Sulbenicillin / Q000008:administration & dosage*
chemical_list: D007612:Kanamycin; D000583:Amikacin; D013408:Sulbenicillin; D010400:Penicillin G