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. 1978 Jun;13(6):992–996. doi: 10.1128/aac.13.6.992

Comparison of Serum Bactericidal Activity Among Three Antimicrobial Combinations

Jorge Murillo 1,2, Harold C Standiford 1,2, Stephen C Schimpff 2,3, Beverly A Tatem 1
PMCID: PMC352378  PMID: 677866

Abstract

Three antimicrobial combinations, ticarcillin plus cephalothin (T+C), ticarcillin plus gentamicin (T+G), and cephalothin plus gentamicin (C+G), were administered to 105 febrile granulocytopenic cancer patients at the Baltimore Cancer Research Center as part of a multi-institutional prospective randomized antibiotic trial. The sera from 32 of these patients (T+C−10 patients, T+G−10 patients, and C+G−12 patients) obtained 1 h post-antibiotic administration were examined for bactericidal activity against 11 strains each of the most common pathogens infecting the granulocytopenic host: Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus. Each of the three antibiotic regimens produced a high degree of bactericidal activity in these sera against S. aureus and E. coli. P. aeruginosa was equally, although poorly, killed by sera containing ticarcillin (T+G, T+C), whereas C+G produced no measurable serocidal activity (P < 0.05). Sera with C+G killed K. pneumoniae more effectively than T+G; T+C produced the least killing effect of the three regimens against this organism (P < 0.05). The bactericidal activity of the serum from these 32 patients supplements the overall clinical results of the multi-institutional antibiotic trial and suggests that T+G is a useful initial regimen for empiric therapy of febrile episodes in granulocytopenic cancer patients.

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Selected References

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

  1. Bennett J. V., Brodie J. L., Benner E. J., Kirby W. M. Simplified, accurate method for antibiotic assay of clinical specimens. Appl Microbiol. 1966 Mar;14(2):170–177. doi: 10.1128/am.14.2.170-177.1966. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bodey G. P., Buckley M., Sathe Y. S., Freireich E. J. Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med. 1966 Feb;64(2):328–340. doi: 10.7326/0003-4819-64-2-328. [DOI] [PubMed] [Google Scholar]
  3. Bodey G. P. Infections in cancer patients. Cancer Treat Rev. 1975 Jun;2(2):89–128. doi: 10.1016/s0305-7372(75)80005-3. [DOI] [PubMed] [Google Scholar]
  4. Bodey G. P., Whitecar J. P., Jr, Middleman E., Rodriguez V. Carbenicillin therapy for pseudomonas infections. JAMA. 1971 Oct 4;218(1):62–66. [PubMed] [Google Scholar]
  5. Dale D. C., Reynolds H. Y., Pennington J. E., Elin R. J., Herzig G. P. Experimental Pseudomonas pneumonia in leukopenic dogs: comparison of therapy with antibiotics and granulocyte transfusions. Blood. 1976 May;47(5):869–876. [PubMed] [Google Scholar]
  6. Ervin F. R., Bullock W. E., Jr, Nuttall C. E. Inactivation of gentamicin by penicillins in patients with renal failure. Antimicrob Agents Chemother. 1976 Jun;9(6):1004–1011. doi: 10.1128/aac.9.6.1004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. HERSH E. M., BODEY G. P., NIES B. A., FREIREICH E. J. CAUSES OF DEATH IN ACUTE LEUKEMIA: A TEN-YEAR STUDY OF 414 PATIENTS FROM 1954-1963. JAMA. 1965 Jul 12;193:105–109. doi: 10.1001/jama.1965.03090020019005. [DOI] [PubMed] [Google Scholar]
  8. 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]
  9. Kluge R. M., Standiford H. C., Tatem B., Young V. M., Schimpff S. C., Greene W. H., Calia F. M., Hornick R. B. The carbenicillin-gentamicin combination against Pseudomonas aeruginosa. Correlation of effect with gentamicin sensitivity. Ann Intern Med. 1974 Nov;81(5):584–587. doi: 10.7326/0003-4819-81-5-584. [DOI] [PubMed] [Google Scholar]
  10. Levine A. S., Schimpff S. C., Graw R. G., Jr, Young R. C. Hematologic malignancies and other marrow failure states: progress in the management of complicating infections. Semin Hematol. 1974 Apr;11(2):141–202. [PubMed] [Google Scholar]
  11. Noone P., Pattison J. R. Therapeutic implications of interaction of gentamicin and penicillins. Lancet. 1971 Sep 11;2(7724):575–578. doi: 10.1016/s0140-6736(71)92152-0. [DOI] [PubMed] [Google Scholar]
  12. Riff L. J., Jackson G. G. Laboratory and clinical conditions for gentamicin inactivation by carbenicillin. Arch Intern Med. 1972 Dec;130(6):887–891. [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. Young L. S., Martin W. J., Meyer R. D., Weinstein R. J., Anderson E. T. Gram-negative rod bacteremia: microbiologic, immunologic, and therapeutic considerations. Ann Intern Med. 1977 Apr;86(4):456–471. doi: 10.7326/0003-4819-86-4-456. [DOI] [PubMed] [Google Scholar]

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