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document
Carbenicillin-trimethoprim/sulfamethoxazole versus carbenicillin-gentamicin as empiric therapy of infection in granulocytopenic patients . A prospective , randomized , double-blind study . The results of therapy with carbenicillin plus trimethoprim-sulfamethoxazole ( C-T/S ) were compared to those obtained with carbenicillin plus gentamicin ( C-G ) in a prospective double-blind study of empiric antibiotic therapy in granulocytopenic patients . Patients were stratified into two groups : favorable-prognosis , group 1 ( carcinoma , lymphoma , multiple myeloma ) , or unfavorable-prognosis , group 2 ( acute leukemia , bone marrow transplantation ) , based on anticipated duration of granulocytopenia . Over-all , empiric antibiotic trials were more often successful ( P = 0.004 ) in group 1 ( 55 of 62 patients or 89 per cent ) than in group 2 ( 42 of 64 patients , 66 per cent ) mwithin group 1 , there was a favorable outcome in 30 of 32 ( 94 per cent ) C-T/S trials and in 25 of 30 ( 83 per cent ) C-G trials ( P = 0.25 ) ; within group 2 , there was a favorable outcome in 23 of 30 ( 77 per cent ) C-T/S trials and in 19 of 34 ( 56 per cent ) C-G trials ( P = 0.14 ) , Combined results in both groups indicated a higher proportion of favorable outcome in C-T/S trials ( 53 of 62 , 85 per cent ) than in C-G trials ( 44 of 64 , 69 per cent ) . Further analysis ( Manetl-Naenszel test ) showed the over-all difference in outcome to be significant ( P = 0.049 ) , but the general applicability of this result may be limited by the rather low incidence of gram-negative bacterial infections in this study . There was no difference between the treatment regimens in antibiotic toxicity , and serious superinfection occurred only in group 2 patients ( 21 per cent of trials ) , equally divided between treatment arms . Initial protocol dosing achieved target plasma levels of trimethoprim ( 3 to 8 micrograms/ml ) or gentamicin ( 4 to 10 micrograms/ml ) in 57 of 68 ( 84 per cent ) C-T/S trials compared to 21 of 60 ( 35 per cent ) C-G trials .
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Intervention_Pharmacological
Carbenicillin-trimethoprim/sulfamethoxazole versus carbenicillin-gentamicin
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Intervention_Pharmacological
carbenicillin plus trimethoprim-sulfamethoxazole ( C-T/S ) were compared to those obtained with carbenicillin plus gentamicin ( C-G )
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Outcome_Other
successful
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Outcome_Other
favorable outcome
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Outcome_Other
favorable outcome
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Outcome_Physical
analysis ( Manetl-Naenszel test
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Outcome_Other
no difference
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Outcome_Physical
antibiotic toxicity
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Outcome_Physical
serious superinfection
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Participant_Condition
granulocytopenic
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Participant_Condition
granulocytopenic
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Participant_Sample-size
two
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Participant_Sample-size
group 1
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Participant_Condition
carcinoma
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Participant_Condition
lymphoma
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Participant_Condition
multiple myeloma
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Participant_Sample-size
group 2
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Participant_Condition
acute leukemia
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Participant_Condition
bone marrow transplantation
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Participant_Condition
granulocytopenia