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. 1980 Sep;18(3):437–442. doi: 10.1128/aac.18.3.437

Carbenicillin plus cefazolin with or without mecillinam as an early treatment of bacteremia caused by gram-negative organisms: randomized double-blind study.

J Klastersky, L Coppens, F Meunier-Carpentier, A P Menday
PMCID: PMC284019  PMID: 6252835

Abstract

Mecillinam or a placebo was added to a combination of cefazolin and carbenicillin as an early therapy of septicemia caused by gram-negative organisms in patients with serious underlying diseases, none of whom was neutropenic, however. Patients in whom infection was caused by pathogens against which mecillinam and cefazolin or mecillinam and carbenicillin were synergistic might have responded more often than patients treated with nonsynergistic combinations. However, overall results did not show any benefit from combining mecillinam with cefazolin and carbenicillin. This study suggests that in nonneutropenic patients with septicemia caused by gram-negative organisms, there is no need to intensify antimicrobial therapy beyond a certain point of efficacy. The measurement of the bactericidal activity in the serum of treated patients might serve as guide for adequate therapy.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson E. T., Young L. S., Hewitt W. L. Antimicrobial synergism in the therapy of gram-negative rod bacteremia. Chemotherapy. 1978;24(1):45–54. doi: 10.1159/000237759. [DOI] [PubMed] [Google Scholar]
  2. Bodey G. P., Valdivieso M., Feld R., Rodriguez V., McCredie K. Carbenicillin plus cephalothin or cefazolin as therapy for infections in neutropenic patients. Am J Med Sci. 1977 May-Jun;273(3):309–318. [PubMed] [Google Scholar]
  3. Grunberg E., Cleeland R., Beskid G., DeLorenzo W. F. In vivo synergy between 6 beta-amidinopenicillanic acid derivatives and other antibiotics. Antimicrob Agents Chemother. 1976 Apr;9(4):589–594. doi: 10.1128/aac.9.4.589. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Gurwith M., Brunton J. L., Lank B., Ronald A. R., Harding G. K., McCullough D. W. Granulocytopenia in hospitalized patients. II. A prospective comparison of two antibiotic regimens in the empiric therapy of febrile patients. Am J Med. 1978 Jan;64(1):127–132. doi: 10.1016/0002-9343(78)90188-2. [DOI] [PubMed] [Google Scholar]
  5. Klastersky J., Cappel R., Daneau D. Clinical significance of in vitro synergism between antibiotics in gram-negative infections. Antimicrob Agents Chemother. 1972 Dec;2(6):470–475. doi: 10.1128/aac.2.6.470. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Klastersky J. Combinations of antibiotics for therapy of severe infections in cancer patients. Eur J Cancer. 1979;15 (Suppl):3–13. [PubMed] [Google Scholar]
  7. Klastersky J., Daneau D., Swings G., Weerts D. Antibacterial activity in serum and urine as a therapeutic guide in bacterial infections. J Infect Dis. 1974 Feb;129(2):187–193. doi: 10.1093/infdis/129.2.187. [DOI] [PubMed] [Google Scholar]
  8. Klastersky J., Henri A., Hensgens C., Daneau D. Gram-negative infections in cancer. Study of empiric therapy comparing carbenicillin-cephalothin with and without gentamicin. JAMA. 1974 Jan 7;227(1):45–48. doi: 10.1001/jama.227.1.45. [DOI] [PubMed] [Google Scholar]
  9. Klastersky J., Hensgens C., Debusscher L. Empiric therapy for cancer patients: comparative study of ticarcillin-tobramycin, ticarcillin-cephalothin, and cephalothin-tobramycin. Antimicrob Agents Chemother. 1975 May;7(5):640–645. doi: 10.1128/aac.7.5.640. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Klastersky J., Meunier-Carpentier F., Prevost J. M. Significance of antimicrobial synergism for the outcome of gram negative sepsis. Am J Med Sci. 1977 Mar-Apr;273(2):157–167. doi: 10.1097/00000441-197703000-00005. [DOI] [PubMed] [Google Scholar]
  11. Neu H. C. Mecillinam, a novel penicillanic acid derivative with unusual activity against gram-negative bacteria. Antimicrob Agents Chemother. 1976 May;9(5):793–799. doi: 10.1128/aac.9.5.793. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Schimpff S. C., Landesman S., Hahn D. M., Standiford H. C., Fortner C. L., Young V. M., Wiernik P. H. Ticarcillin in combination with cephalothin or gentamicin as empiric antibiotic therapy in granulocytopenic cancer patients. Antimicrob Agents Chemother. 1976 Nov;10(5):837–844. doi: 10.1128/aac.10.5.837. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Schimpff S., Satterlee W., Young V. M., Serpick A. Empiric therapy with carbenicillin and gentamicin for febrile patients with cancer and granulocytopenia. N Engl J Med. 1971 May 13;284(19):1061–1065. doi: 10.1056/NEJM197105132841904. [DOI] [PubMed] [Google Scholar]
  14. Spratt B. G. The mechanism of action of mecillinam. J Antimicrob Chemother. 1977 Jul;3 (Suppl B):13–19. doi: 10.1093/jac/3.suppl_b.13. [DOI] [PubMed] [Google Scholar]
  15. Tybring L. Mecillinam (FL 1060), a 6beta-amidinopenicillanic acid derivative: in vitro evaluation. Antimicrob Agents Chemother. 1975 Sep;8(3):266–270. doi: 10.1128/aac.8.3.266. [DOI] [PMC free article] [PubMed] [Google Scholar]

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