Timentin in combination with tobramycin as empirical therapy in febrile neutropenic patients with haematological malignancies

J Antimicrob Chemother. 1986 May:17 Suppl C:211-7. doi: 10.1093/jac/17.suppl_c.211.

Abstract

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Agranulocytosis / complications
  • Anemia, Aplastic / complications
  • Bacteria / drug effects
  • Bacteria / isolation & purification
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / etiology
  • Bacterial Infections / microbiology
  • Clavulanic Acids / administration & dosage
  • Clavulanic Acids / pharmacology
  • Clavulanic Acids / therapeutic use*
  • Drug Combinations / administration & dosage
  • Drug Combinations / pharmacology
  • Drug Combinations / therapeutic use
  • Drug Evaluation
  • Drug Therapy, Combination
  • Female
  • Fever / drug therapy*
  • Fever / etiology
  • Humans
  • Leukemia / complications
  • Male
  • Middle Aged
  • Neutropenia / etiology
  • Penicillin Resistance
  • Penicillins / therapeutic use*
  • Ticarcillin / administration & dosage
  • Ticarcillin / pharmacology
  • Ticarcillin / therapeutic use*
  • Tobramycin / administration & dosage
  • Tobramycin / pharmacology
  • Tobramycin / therapeutic use*

Substances

  • Clavulanic Acids
  • Drug Combinations
  • Penicillins
  • ticarcillin-clavulanic acid
  • Ticarcillin
  • Tobramycin