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January 7, 1974

Gram-Negative Infections in Cancer: Study of Empiric Therapy Comparing Carbenicillin-Cephalothin With and Without Gentamicin

Author Affiliations

From the Service de Médecine et Laboratoire d'Investigation Clinique (Section des Maladies Infectieuses), Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Brussels, Brussels.

JAMA. 1974;227(1):45-48. doi:10.1001/jama.1974.03230140019004

The combination of carbenicillin disodium and cephalothin sodium was compared in a double-blind study with that of carbenicillin, cephalothin, and gentamicin sulfate therapy in patients with disseminated cancer. These therapies were used empirically prior to recognition of the offending pathogen; however, only infections caused by Gram-negative bacilli were used for the evaluation of the two combinations. A favorable clinical response was observed in 32 (80%) of 40 patients who received carbenicillin and cephalothin and in 31 (76%) of those who received carbenicillin, cephalothin, and gentamicin therapy. The antibacterial activity of the sera of the patients was similar whether the double- or the triple-drug regimen was given. The administration of carbenicillin, cephalothin, and gentamicin was associated with a higher incidence of untoward effects, especially azotemia, than was that of carbenicillin and cephalothin.