Seventy-four febrile patients with leukaemia or malignant lymphoma, of whom 42 had severe granulocytopenia, were treated with netilmicin in combination with other antibiotics, usually ampicillin and methicillin. Of 36 patients with proven bacterial infection, 72% responded to treatment with complete resolution or improvement. Moderate and reversible renal affection occurred in 10 patients of whom 8 concomitantly were treated with other potentially nephrotoxic drugs. Five of the 10 patients had unintendedly high valley concentrations of netilmicin. Ototoxicity was not documented. It is concluded that netilmicin is an effective and tolerable aminoglycoside.

Bacterial Infections↗

PubMed1979

Pseudomonas cepacia in 16 non-fatal cases of postoperative bacteremia derived from intrinsic contamination of the anaesthetic fentanyl. Clinical and epidemiological observations in Denmark and Holland.

From Nov. 15 to Dec. 17, 1977, Pseudomonas cepacia was isolated from the blood of 16 patients in Odense, Denmark, and Nijmegen, Holland, 2--5 days after an operation with general anaesthesia. The fever started 14--70 h after operation and lasted 2--4 days. All patients recovered. 14/15 patients examined 7--51 days later had agglutinating antibody titres of 400-3,200 against the epidemic strain. Ps. cepacia with identical biochemical characters and sensitivity pattern was isolated from unbroken vials containing the anaesthetic fentanyl, which had been given to all 16 patients. Two batches were contaminated, one heavily so (10(4)--10(5) cfu/0.1 ml). Seven other batches examined yielded no growth. The preservative added to the vials was a mixture of methyl- and propyl-p-hydroxybenzoates which not only allowed growth of the Ps. cepacia strain but could also serve as a carbon source as did citric and malonic acids. The concentration of preservative was not reduced in contaminated vials. The vials had not been sterilized after closure; too much reliance had been placed on an aseptic technique and insufficient preservatives.

Adult↗

PubMed1978

Clinical experience with bacteraemia in patients with leukaemia and allied neoplastic diseases.

134 bacteraemic episodes in 112 patients with leukaemia and allied disorders over a 5-year period were reviewed. The patients were divided, with respect to neoplastic disease, into 3 prognostic groups according to estimated periods of survival of years (group 1), months (group II) or weeks (group III). High mortality was correlated to group III, gram-negative rod bacteraemia and septic shock. Low leucocyte levels and intensive antineoplastic treatment did not adversely influence the prognosis of the bacteraemic patients. Appropriate antibiotic therapy was correlated with a significantly lower mortality, and it is concluded that aggressive antibiotic therapy is indicated when bacteraemia is suspected from clinical judgement.

Anti-Bacterial Agents↗

PubMed1976

Bacteraemia in patients with leukaemia and allied neoplastic diseases.

94 episodes of bacteraemia were demonstrated in 79 patients with leukaemia and allied disorders over a 3-year period. The relative proportions of different microorganisms differed from that of an unselected Danish material in the high proportion of Pseudomonas aeruginosa bacteraemias, and from studies from other centers for cancer treatment in the high proportion of cases where gram-positive cocci were isolated. 70% of the Staphylococcus aureus strains were fully sensitive to antibiotics or resistant only to penicillin G. A liberal use of penicillins and aminoglycoside antibiotics was employed in the department. No outbreaks attributable to cross infection with a single variety of Staph. aureus or Ps. aeruginosa strains were found during the study.

Anti-Bacterial Agents↗

PubMed1973