Cephalothin, carbenicillin, and gentamicin combination therapy for febrile patients with acute non-lymphocytic leukemia

The effectiveness of combination antibiotic therapy with cephalothin, carbenicillin, and gentamicin was evaluated in febrile adults with acute nonlymphocytic leukemia undergoing aggressive induction chemotherapy. In all patients, upon developing a temperature of 101F, cultures were obtained and the three antibiotics were initiated. Twenty-seven adults had 51 febrile episodes; marked granulocytopenia was present during 50. There were 33 documented infections (including 18 septicemias, 11 pneumonias, and 4 perirectal abscesses), 5 probable infections, and 13 fevers of unidentified origin. of 33 documented infections, 27 (82%) cleared, 2 (6%) probably cleared, and 4 (12%) persisted. There were two fungal superinfections and no bacterial superinfections. Azotemia developed in 12 of 48 episodes; the serum potassium fell in 20 of 33 episodes. Cephalothin, carbenicillin, and gentamicin appear to be an effective combination with acceptable toxicity for empirical therapy of febrile episodes occurring in adults with active acute leukemia.