Prophylaxis Against Septicemia in Acute Leukemia: The Use of Oral Framycetin

Septicaemia during remission-induction therapy for acute leukaemia has been a major limiting factor in treatment of the disease and highly expensive regimes have been advocated to reduce this complication. In the present study the use of simple prophylaxis against septicaemia arising from the bowel has been analysed. Framycetin was administered orally to a group of 38 patients with acute leukaemia during remission- induction therapy, and a comparison was made of the incidence of septicaemia and other infections in this group and a further 66 patients similarly treated for leukaemia but given no such prophylaxis. The incidence of septicaemia in the framycetin group was reduced to 51% of that in the untreated group. This reduction was noted with both Grampositive and Gram-negative organisms, including Escherichia coli (36%) and Pseudomonas aeruginosa (24%), and was seen at all degrees of neutropenia. No decrease in the number of other infective episodes was noted. The treated group spent a smaller proportion of their hospital stay receiving systemic antibiotics (39-4% v. 46-7%) or with a fever greater than 38° C (27-0% v. 39-8%). .Framycetin was easy to administer orally, was associated with few side effects, and provides benefits which approach those of very much more complex and expensive regimens.