[Clinical effects of combination therapy with cefozopran and tobramycin for severe infections in patients with hematologic diseases].
We studied clinical effect of a combination therapy with cefozopran (CZOP) and tobramycin (TOB) for infections in 80 patients with hematologic diseases in 15 institutes. Combined doses with CZOP 2 g and TOB 60-90 mg twice a day had been given intravenously. Of the 80 patients, 61 patients (42 with acute leukemia, 10 with malignant lymphoma, 3 with aplastic anemia, 2 with chronic myeloid leukemia, 2 with multiple myeloma, and 2 with myelodysplastic syndrome) were evaluable. Those consisted of 6 patients with septicemia, 49 with suspected septicemia, 3 with pneumonia, and 3 with other infections. Clinical efficacy by the treatment was excellent in 24, good in 17, fair in 9, and poor in 11 patients, and the overall efficacy rate including excellent and good was 67.2%. Microbiologically, 5 of the 6 patients with septicemia (1 coagulase negative Staphylococcus, 2 S. pneumoniae, 1 S. oralis, and 1 E. coli) were responded. The efficacy rate in patients with severe granulocytopenia showing 100/microliter or lesser neutrophil counts during the drug administration was 57.1% (12/21). Side effects and abnormal changes of clinical laboratory findings were observed in 5 patients, and 16 patients, respectively, but most of them were mild. The findings above suggested that the combination therapy with CZOP and TOB is useful as an empiric therapy for severe infections in patients with hematologic diseases.
Toyama
K
K
First Department of Internal Medicine, Tokyo Medical University.
Yaguchi
M
M
Uchida
Y
Y
Suzuki
K
K
Sawanobori
M
M
Ikeda
Y
Y
Matsuoka
S
S
Wakasugi
K
K
Furuya
T
T
Oshimi
K
K
Kawamata
N
N
Kikuchi
M
M
Murakami
H
H
Tsuruoka
N
N
Tomoyasu
S
S
Kawaguchi
M
M
Hirosawa
S
S
Yamamoto
K
K
Shirota
T
T
Harada
Y
Y
Dan
K
K
Yamada
T
T
Kawano
K
K
Onozawa
Y
Y
Takeuchi
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002511:Cephalosporins / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D007239:Infections / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000188:drug therapy; D014031:Tobramycin / Q000008:administration & dosage* / Q000009:adverse effects; D000097586:Cefozopran
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D014031:Tobramycin; D000097586:Cefozopran