Gorin N C, Tessier F, Najman A, Duhamel G, Andre R
Sem Hop. 1975 Jun 14;51(28):1927-33.
The association of carbenicillin and gentamicin was used as a routine in the early treatment of 48 attacks of fever, in 38 patients who mostly had acute leukemia and marrow aplasia. The attacks of infection may be classified as follows: 30% septicemia, 30% local infections, 40% no bacteria were identified. Among the septicemias, we noted 5 septicemias due to pyocyaneus, 4 due to klebsiella. On the whole, in the attacks of fever, the association of carbenicillin and gentamicin proved effective in 70% of cases, but a cure was obtained in only 56% of cases. In vitro, the association carbenicillin-gentamicin proved justified in 70% of cases. There was no special intolerance, apart from a few cases of hypokalemic alkalosis. The association carbenicillin-gentamicin, by its broad spectrum and especially in view of its elective effect on the pyocyaneus is an excellent initial form of antibiotic therapy, when faced with infection in a patient with malignant blood disease. However, it should be recognised that the efficacy of this association depends on the number of circulating polynuclear cells and that some bacteria, such as the klebsiella, are clear cells and that some bacteria, such as the klebsiella, are often resistant to this antibiotic association.
羧苄青霉素与庆大霉素联合用药在48例发热发作的早期治疗中作为常规使用，这些患者大多患有急性白血病和骨髓发育不全。感染发作可分类如下：30%为败血症，30%为局部感染，40%未发现细菌。在败血症病例中，我们注意到5例由绿脓杆菌引起，4例由克雷伯氏菌引起。总体而言，在发热发作中，羧苄青霉素与庆大霉素联合用药在70%的病例中证明有效，但仅在56%的病例中治愈。在体外，羧苄青霉素 - 庆大霉素联合用药在70%的病例中证明是合理的。除了少数低钾性碱中毒病例外，没有特殊的不耐受情况。羧苄青霉素 - 庆大霉素联合用药，因其广谱性，特别是鉴于其对绿脓杆菌的选择性作用，在面对恶性血液病患者的感染时是一种极好的初始抗生素治疗形式。然而，应该认识到这种联合用药的疗效取决于循环多核细胞的数量，并且某些细菌，如克雷伯氏菌，对这种抗生素联合用药常常耐药。
