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Current Guidelines on the Use of Antibacterial Drugs in Patients with Malignancies

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Summary

Patients with malignant disease may be predisposed to bacterial infections because of neoplastic disruption of normal tissue barriers, exogenous immunosuppressive therapy (drugs with or without radiation), and intrinsic host immune deficits secondary to these diseases. Diminished polymorphonuclear leucocyte numbers or function and impaired humoral immunity are highly correlated with the development of serious bacterial infections. The usual signs and symptoms of infection may be absent or altered in a compromised host.

Therapy must be instituted promptly upon clinical suspicion of bacterial infection, and empirical choices should usually include combinations that are synergistic for likely pathogens based on knowledge of the local predominant flora and susceptibility data. Synergism has most often been demonstrated in combinations that utilise a β-lactam (semisynthetic penicillin or cephalosporin) and an aminoglycoside. Triple drug therapy has not been shown to be advantageous. Monotherapy with third generation cephalosporins, carbapenems, monobactams, or ureidopenicillins has not been proven to offer advantages over 2-drug regimens for these patients.

Granulocytopenic patients who respond to 2-drug therapy but remain neutropenic may need continued treatment until the neutropenia subsides. Those who do not respond and remain febrile with an unclear focus may need to be started on antifungal therapy in addition to the antibacterial agent. The use of oral agents for the prophylaxis of neutropenic patients against bacteraemia remains controversial. If drugs are used, co-trimoxazole and nystatin suspension may be preferable.

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References

  • Acar, J.F.; Sabath, L.D. and Ruch, P.A.: Antagonism of the antibacterial action of some penicillins by other penicillins and cephalosporins. Journal of Clinical Investigation 55: 446–453 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Baehncr, R.L.; Neiburger, R.G.; Johnson, D.E. and Murrmann, S.M.: Transient bactericidal defect of peripheral blood phagocytes from children with acute lymphoblastic leukemia receiving craniospinal irradiation. New England Journal of Medicine 289: 1209–1213 (1973).

    Article  Google Scholar 

  • Barza, M.: Antimicrobial spectrum, pharmacology, and therapeutic use of antibiotics. Part 2: Penicillins. American Journal of Hospital Pharmacy 34: 57–67 (1977).

    PubMed  CAS  Google Scholar 

  • Barza. M. and Miao, P.V.W.: Antimicrobial spectrum, pharmacology, and therapeutic use of antibiotics. Part 3: Cephalosporins. American Journal of Hospital Pharmacy 34: 621–629 (1977).

    PubMed  CAS  Google Scholar 

  • Bender, J.F.; Former, C.L.; Schimpft, S.C.; Grove, W.R.; Hahn, D.M.: Love, L.J. and Wiernik, P.: Comparative auditory toxicity of aminoglycoside antibiotics in leukopenic patients. American Journal of Hospital Pharmacy 36: 1083–1087 (1979).

    PubMed  CAS  Google Scholar 

  • Bergeron, M.G.; Brusch, J.L.; Barza, M. and Weinstein, L.: Bacterial activity and pharmacology of cefazolin. Antimicrobial Agents and Chemotherapy 4: 396–401 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Bloomfield, C.D. and Kennedy, B.J.: Cephalothin, carbenicillin and gentamicin combination therapy for febrile patients with acute non-lymphocytic leukemia. Cancer 34: 431–437 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Bode, F..R.; Pare, J.A. and Fraser, R.G.; Pulmonary diseases in the compromised host: A review of clinical and roentgenographic manifestations in patients with impaired host defense mechanisms. Medicine 53: 255–293 (1974).

    PubMed  CAS  Google Scholar 

  • Bodey, G.P.: Infections in cancer patients. Cancer Treatment Report 2: 89 (1975).

    Article  CAS  Google Scholar 

  • Bodey, G.P.; Buckley, M.; Sathe, Y.S. and Freireich, E.J.: Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Annals of Internal Medicine 64: 328–340 (1966).

    PubMed  CAS  Google Scholar 

  • Bodey, G.P.; Grose, W.E. and Keating, M.J.: Use of trimethoprim-sulfamethoxazole for treatment of infections in patients with cancer. Reviews of Infectious Diseases 4: 579–585 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Bodey, G..P.; Ketchel, S.J. and Rodriguez, V.: A randomized study of carbenicillin plus cefamandole or tobramycin in the treatment of febrile episodes in cancer patients. American Journal of Medicine 67: 608–616 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Bodey, G.P. and Rodriguez, V..: Advances in the management of Pseudomonas aeruginosa infections in cancer patients. European Journal of Cancer 9: 435–441 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Boggs, D.R. and Frei, E. III: Clinical studies of fever and infection in cancer. Cancer 13: 1240–1253 (1960).

    Article  Google Scholar 

  • Browder, A.A.; Huff, J.W. and Petersdorf, R.G.: The significance of fever in neoplastic disease. Annals of Internal Medicine 55: 932–942 (1961).

    PubMed  CAS  Google Scholar 

  • Brown, C.H. III: Study of the effects of ticarcillin on blood coagulation and platelet function. Antimicrobial Agents and Chemotherapy 7: 652 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Brown, C.H.; Natelson, E.A.; Bradshaw, W.; Williams, T.W. Jr and Alfrey, C.P. Jr: The hemostatic defect produced by carbenicillin. New England of Medicine 291: 265–270 (1974).

    Article  CAS  Google Scholar 

  • Buchner, L.H. and Schneierson, S.S.: Clinical and laboratory aspects of Listeria monocvtogenes infections with a report of ten cases. American Journal of Medicine 45: 904–921 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Casazza, A.R.; Duvall, C.P. and Carbone, P.P.: Infection in lymphoma: Histology, treatment, and duration in relation to incidence and survival. Journal of the American Medical Association 197: 710–716 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Cunha, B.A. and Ristuccia, A.M.: Third generation cephalosporins. Medical Clinics of North America 66: 283–291 (1981).

    Google Scholar 

  • Dahlgren, J.G.; Anderson, E.T. and Hewitt, W.L.: Gentamicin blood level, a guide to nephrotoxicity. Antimicrobial Agents and Chemotherapy 8: 58–62 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Desser, R.K. and Ultmann, J.E.: Risk of severe infection in patients with Hodgkin’s disease or lymphoma after diagnostic laparotomy and splenectomy. Annals of Internal Medicine 77: 143–146 (1972).

    PubMed  CAS  Google Scholar 

  • Dinarello, C.A. and Wolff, S.M.: Molecular basis of fever in humans. American Journal of Medicine 72: 799–813 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Drusano, G.L.; Schimpff, C. and Hewitt, W.L.: The acylampicillins: Mezlocillin, piperacillin, and azlocillin. Reviews of Infectious Diseases 6: 13–32 (1984).

    Article  PubMed  CAS  Google Scholar 

  • Dudley, M.N. and Barriere, S.L.: Cefotaxime: Microbiology, pharmacology and clinical use. Clinical Pharmacy 1: 114–124 (1982).

    PubMed  CAS  Google Scholar 

  • Duprez, P. and Michaux, J.L.; Piperacillin or cefotaxime plus amikacin: Result of empirical antibiotic therapy for febrile episodes in granulocytic patients. Current Chemotherapy and Immunotherapy. Proceedings of the 12th International Congress of Chemotherapy, Florence, Italy, July 19–24 (1981).

  • Edson, R.S. and Keys, T.F.: The aminoglycosides. Mayo Clinic Proceedings 58: 99–102 (1983).

    PubMed  CAS  Google Scholar 

  • Eliopoulos, G.M. and Moellering, R.C.: Azlocillin, mezlocillin and piperacillin: New broad-spectrum penicillins. Annals of Internal Medicine 97: 755–760 (1982).

    PubMed  CAS  Google Scholar 

  • Eron, L.J.; Durrer, F.; Goldberg, R.I. and Poretz, D.M.: N-Formimidoly thienamycin versus moxalactam in the treatment of serious infections. Abstract of paper presented at the 23rd International Congress of Chemotherapy, Las Vegas, Nevada, October 24–26 (1983).

  • European Organization for Research on Treatment of Cancer — International Antimicrobial Therapy Project Group: Three antibiotic regimens in the treatment of infection in febrile, granulocytopenic patients with cancer. Journal of Infectious Diseases 137: 14–29 (1978).

    Article  Google Scholar 

  • Fainstein, F.; Bodey, G.P.; McCredie, K.B.; Keating, M.J.; Estey, E.H.; Bolivar, R. and Elting, L: Coagulation abnormalities induced by β-laciam antibiotics in cancer patients. Journal of Infectious Diseases 148: 745–750 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Faser, D.G.: Drug therapy reviews: Antimicrobial spectrum, pharmacology and therapeutic use of cefamandole and cefoxitin. American Journal of Hospital Pharmacy 36: 1503–1508 (1979).

    Google Scholar 

  • Geddes, A.M. and Davey, P.G.: The compromised host and antibacterial treatment. Scandinavian Journal of Infectious Diseases (Suppl. 23): 161–166 (1980).

  • Gentry, L.O.; Jemsed, J.G. and Natelson, E.A.: Effects of sodium piperacillin on platelet function in normal volunteers. Antimicrobial Agents and Chemotherapy 19: 532–533 (1981).

    Article  PubMed  CAS  Google Scholar 

  • Guay, D.R.P.: Netilmicin. Drug Intelligence and Clinical Pharmacy 17: 83–91 (1983).

    PubMed  CAS  Google Scholar 

  • Gurwith, M.J.; Brunton, J.L.; Lank, B.A.; Harding, G.K.M. and Ronald, A.R.: A prospective controlled investigation of prophylactic trimethoprim/sulfamethoxazole in hospitalized granulocytopenic patients. American Journal of Medicine 66: 248–256 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Hersh, E.M.; Bodey, G.P.; Nies, B.A. and Freireich, E.J.: Causes of death in acute leukemia. Journal of the American Medical Association 193: 105–109(1965).

    Article  PubMed  CAS  Google Scholar 

  • Hersh, E.M. and Freireich, E.J.: Host defence mechanisms and their modification by cancer chemotherapy; in Busch (Ed.) Methods in Cancer Research, pp. 355–361 (Academic Press, New York 1968).

    Google Scholar 

  • Higby, DJ.; Yates, J.W., Henderson, M.D. and Holland, J.D.: Filtration leukapharesis for granulocyte transfusion therapy. New England Journal of Medicine 292: 761–766 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Holmes, K.K.; Clark, H.; Silverblatt, F. and Turck, M.: Emergence of resistance in Pseudomonas during carbenicillin therapy. Antimicrobial Agents and Chemotherapy 8: 391–397 (1969).

    Google Scholar 

  • Hughes, W.T.; Feldman, S. and Cox, F.: Infectious diseases in children with cancer. Pediatric Clinics of North America 21: 583–615 (1974).

    PubMed  CAS  Google Scholar 

  • Hughes, W.T.; Kuhn, S.; Chaudhary, S.; Feldman, S.; Verzosa, M.; Aur, R.J.A.; Pratt, G and George, S.L.: Successful chemoprophlyaxis for Pneumocystis carinii pneumonitis. New England Journal of Medicine 297: 1419–1426 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Inagaki, J.; Rodriguez, V. and Bodey, G.P.: Causes of death in cancer patients. Cancer 33: 568–573 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Issell, B.F. and Bodey, G.P.: Mezlocillin for treatment of infections in cancer patients. Antimicrobial Agents and Chemotherapy 17: 1008–1013 (1980).

    Article  PubMed  CAS  Google Scholar 

  • Jick, H.: Adverse reactions to trimethoprim-sulfamethoxazole in hospitalized patients. Reviews of Infectious Diseases 4: 426–428 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Keating, M.J.; Bodey, G.P.; Valdivieso, M. and Rodriguez, V.: A randomized comparative trial of three aminoglycosides — comparison of continuous infusions of gentamicin, amikacin, and sisomicin combined with carbenicillin in the treatment of infeclions in neutropenic patients with malignancies. Medicine 58: 159–169 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Keating. M.J.: Lawson. R.: Grose, W. and Bodey, G.P.: Combination therapy with ticarcillin and sulfamethoxazole-trimethoprim for infections in patients with cancer. Archives of Internal Medicine 141: 926–930 (1981).

    Article  PubMed  CAS  Google Scholar 

  • Klastersky. J.: Empiric treatment of infections in neutropenic patients with cancer. Reviews of Infectious Diseases Suppl 6: 521–531 (1983).

    Google Scholar 

  • Klastersky, J.; DeBusscher, L.; Weerts-Ruhl, D. and Prevost, J.M.: Carbenicillin, cefazolin, amikacin as an empiric therapy for febrile granulocytopenic cancer patients. Cancer Treatment Report 61: 1433–1439 (1977).

    CAS  Google Scholar 

  • Klastersky. J.: Hensgens. C. and DeBusscher, L.: Empiric therapy for cancer patients: Comparative study of ticarcillin-tobramycin. ticarcillin-cephalothin. and cephalothin-tobramycin. Antimicrobial Agents and Chemotherapy 7: 640–645 (1975).

    Article  PubMed  CAS  Google Scholar 

  • Lamb. D.: Pilney, F.: Kelly, W.D. and Good, R.A.: A comparative study of the incidence of anergy in patients with carcinoma, leukemia, Hodgkin’s disease and other lymphomas. Journal of Immunology 89: 555–558 (1962).

    CAS  Google Scholar 

  • Latos, D.L.; Bryan, C.S. and Stone, W.J.: Carbenicitlin therapy in patients with normal and impaired renal function. Clinical Pharmacology and Therapeutics 17: 692–700 (1975).

    PubMed  CAS  Google Scholar 

  • Law, D.K.; Dudrick. S.J. and Abdou, N.I.: Immunocompetence of patients with protein-calorie malnutrition. The effects of nutritional repletion. Ann. Intern. Med. 79: 545–550 (1973).

    PubMed  CAS  Google Scholar 

  • Lawson, R.D. and Baskin, R.C: Ceftizoxime treatment of infection in neutropenic patients with malignancies. Journal of Antimicrobial Chemotherapy Suppl. C: 159–165 (1982).

  • Lau. W.K.; Young, L.S.; Black. R.E.; Winston, D.J.; Linné, S.R.; Weinstein. R.J. and Hewitt, W.L.: Comparative efficacy and toxicily of amikocin/carbenicillin versus gentamicin/carbenicillin in leukopenic patients. American Journal of Medicine 62: 959–966 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Louria. D.B.; Hensle. T.; Armstrong, D.; Collins, H.S.; Blevins, A.; Krugman, D. and Buse, M.: Listeriosis complicating malignant disease: A new association. Annals of Internal Medicine 67: 261–281 (1967).

    Google Scholar 

  • Love, L.J.; Schimpff. S.C; Hahn, D.M.; Young V.M.; Standiford, H.C.; Bender. J.F.; Former, C.L. and Wiernik, P.H.: Randomized trial of empiric antibiotic therapy with ticarcillin in combination with gentamicin, amikacin, or netilmicin in febrile patients with granulocytopenia and cancer. American Journal of Medicine 66: 603–610 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Love. L.J.; Schimpff, S.C; Schiffner, C.A.. and Wiernik, P.H: Improved prognosis for granulocytopenic patients with Gram-negative rod bacteria. American Journal of Medicine 68: 643–648 (1980).

    Article  PubMed  CAS  Google Scholar 

  • Lyon, J.A.: Cefoperazone. Drug Intelligence and Clinical Pharmacy 17: 7–11 (1983).

    PubMed  CAS  Google Scholar 

  • Maki, D.G.; Goldman, D.A, and Rhame, F.S.: Infection control in intravenous therapy. Annals of Internal Medicine 79: 867–887 (1973).

    PubMed  CAS  Google Scholar 

  • Medical Letter: Ticarcillin. 19: 17–18(1977).

  • Medical Letter: Antimicrobial prophylaxis and treatment in patients with granulocytopenia. 23 (12): 55–56 (1981).

  • Meyers. B.R.; Hirschman, S.Z. and Axelrod, J.A.: Current patterns of infection in multiple myeloma. American Journal of Medicine 52: 87–92(1972).

    Article  PubMed  CAS  Google Scholar 

  • Melikian, V.; Wise, R.; Allum, W.H. and Wells, W.D.: Mezlocillin and gentamicin in the treatment of infections in seriously ill and immunosupressed patients. Journal of Antimicrobial Chemotherapy 7: 657–663 (1981).

    Article  PubMed  CAS  Google Scholar 

  • Mellin, H.E.; Welling, P.G. and Madsen P.O.: Pharmacokinelics of cefamandole in patients with normal and impaired renal function. Antimicrobial Agents and Chemotherapy 11: 262–266 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Mirsky, H.S. and Cuttner, J.: Fungal infection in acute leukemia. Cancer 30: 348–352(1972).

    Article  PubMed  CAS  Google Scholar 

  • Nauseef, W.M. and Maki, D.G.: A study of the value of simple protective isolation in patients with granulocytopenia. New England Journal of Medicine 304: 448–453 (1981).

    Article  PubMed  CAS  Google Scholar 

  • Noone. P.: Use of antibiotics — aminoglycosides. British Medical Journal 2: 549–552 (1978).

    Article  PubMed  CAS  Google Scholar 

  • Pizzo. P.A.; Robichaud, K.J.; Gill, F.A.; Witebsky, F.G.; Levine, A.S.: Deisseroth, A.B.; Glaubiger, D.L.; Maclowry, J.D.; Magrath, I.T.; Poplack, D.G. and Simon, R.M.: Duration of empiric antibiotic therapy in granulocytopenic patients with cancer. American Journal of Medicine 67: 194–200 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Pizzo. P.A.; Robichaud, J.; Gill, F.A. and Witebsky, F.G.: Empiric antibiotic and antifungal therapy in cancer patients with prolonged fever and granulocytopenia. American Journal of Medicine 72: 101–111 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Polk, R.E.: Moxalactam. Drug Intelligence and Clinical Pharmacy. 16: 104–112 (1982).

    PubMed  CAS  Google Scholar 

  • Poporad. G.A. and Abrutyn, E.: The third-generation cephalosporins: Cefotaxime. moxalactam, and cefoperazone. Hospital Pharmacy 1458–1465 (1982).

  • Prolla, J.C. and Kirsner, J.B.: The gastrointestinal lesions and complications of the leukemias. Annals of Internal Medicine 61: 1084–1103 (1964).

    PubMed  CAS  Google Scholar 

  • Reed, M.D.; Bertino, J.S. Jr; Aroneff, S.C; Speck, W.T. and Blumer. J.L.: Evaluation of moxalactam. Clinical Pharmacy 1: 124–134 (1982).

    PubMed  CAS  Google Scholar 

  • Remington, J.S. and Schimpff. S.C: Please don’t eat the salads. New England Journal of Medicine 304: 433–434 (1981).

    Article  PubMed  CAS  Google Scholar 

  • Rubin. R.H. and Swartz, M.N.: Trimethoprim-sulfamethoxazole. New England Journal of Medicine 303: 426–432 (1980).

    Article  PubMed  CAS  Google Scholar 

  • Russo, J. and Russo, M.E.: Comparative review of two new widespectrum penicillins: Mezlocillin and piperacillin. Clinical Pharmacy 1: 207–216 (1982).

    PubMed  CAS  Google Scholar 

  • Ryan, J.A. Jr; Abel, R.M.; Abbott, W.M.; Hopkins, C.C.; Chesney, T. McC; Colley, R.; Phillips, K. and Fischer, J.E.: Catheter complications in total parenteral nutrition. A prospective study of 200 consecutive patients. New England Journal of Medicine 290: 757–761 (1974).

    Article  PubMed  Google Scholar 

  • Schimpff, S.C; Greene, W.H.; Young, V.M.; Fortner, C.L.; Jepson, L.; Cusack, N.; Block J.B., and Wiernik, P.H.: Infection prevention in acute nonlymphocytic leukemia. Annals of Internal Medicine 82: 351–358 (1975).

    PubMed  CAS  Google Scholar 

  • Schimpff, S.C.: Satterlee, W.; Young, V.M. and Serpick, A.: Empiric therapy with carbenicillin and gentamicin for febrile patients with cancer and granulocytopenia. New England Journal of Medicine 284: 1061–1065 (1971).

    Article  PubMed  CAS  Google Scholar 

  • Schimpff, S.C.; Young, V.M.; Greene, W.H.; Vermeulen, G.D.; Moody, M.R. and Wiernik, P.H.: Origin of infection in acute nonlymphocytic leukemia. Significance of hospital acquisition of potential pathogens. Annals of Internal Medicine 77: 707–714 (1972).

    PubMed  CAS  Google Scholar 

  • Sickles, E.A.; Young, V.M.; Green, W.H. and Wiernik, P.H.: Pneumonia in acute leukemia. Annals of Internal Medicine 79: 528–534 (1973).

    PubMed  CAS  Google Scholar 

  • Simone. J.V.; Holland, E. and Johnson, W.: Fatalities during remission of childhood leukemia. Blood 39: 759–770 (1972).

    PubMed  CAS  Google Scholar 

  • Stossel, T.P.: Phagocytosis. New England Journal of Medicine 290: 717–723, 774–780, 833–839 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Stuart, R.K.; Braine, H.G.; Lietman, P.S.; Saral, R. and Fuller, D.J.: Carbenicillin-trimethoprim/sulfamethoxazole versus carbenicillin-gentamicin as empiric therapy of infection in granulocytopenic patients. American Journal of Medicine 68: 876–885 (1980).

    Article  PubMed  CAS  Google Scholar 

  • Tanaka. S.K.; Schwind, R.A.; Minassian, B.F.; Lalama, L; Bonner, D.P. and Sykes, R.B.: Synergistic activity of aztreonamaminoglycoside combinations against antibiotic resistant and susceptible aerobic Gram-negative bacilli. Abstract of paper presented at the 23rd International Congress of Chemotherapy, Las Vegas, Nevada, October 24–26 (1983).

  • Tattersall, M.H.N.; Spiers, A.S.D. and Darrell, J.H.: Initial therapy with combination of five antibiotics in febrile patients with leukemia and neutropenia. Lancet 1: 162–166 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Thompson, R.L. and Wright, A.J.: Cephalosporin antibiotics. Mayo Clinic Proceedings 58: 79–87 (1983).

    PubMed  CAS  Google Scholar 

  • Tjernström, Ö.: Prospective evaluation of vestibular and auditory function in 76 patients treated with netilmicin. Scandinavian Journal of Infectious Diseases Suppl. 23: 122–125 (1980).

    Google Scholar 

  • Viola, M.V.: Acute leukemia and infection. Journal of the American Medical Association 201: 103–106 (1967).

    Article  Google Scholar 

  • Wade, J.C. and Schimpff, S.C.: Approaches to therapy of bacterial infections in the granulocytopenic patients; in Klastersky (Ed.) Infections in Cancer Patients, pp. 105–129 (Raven Press, New York 1981).

    Google Scholar 

  • Wade, J.C; Schimpff, S.C.; Hargadon, M.T.; Fortner, C.L.; Young, V.M. and Wiernik, P.H.: Comparison of trimethoprim-sulfamethoxazole plus nystatin with gentamicin plus nystatin in the revention of infections in acute leukemia. New England Journal of Medicine 304: 1057–1061 (1981a).

    Article  PubMed  CAS  Google Scholar 

  • Wade. J.C.; Schimpff, S.C; Newman, K.A.; Fortner, C.L.; Moody, M.R.; Young, V.M. and Wiernik, P.H.: Potential of mezlocillin as empiric single agent therapy in febrile granulocytopenic cancer patients. Antimicrobial Agentsand Chemotherapy 18: 299–306 (1980).

    Article  CAS  Google Scholar 

  • Wade, J.C.; Schimpff, S.C.; Newman, K.A.; Fortner, C.L.; Standiford, H.C. and Wiernik, P.H.: Piperacillin or ticarcillin plus amikacin. A double-blind prospective comparison of empiric antibiotic therapy for febrile granulocytopenic cancer patients. American Journal of Medicine 71: 983–990 (1981b).

    Article  PubMed  CAS  Google Scholar 

  • Wade, J.C.; Schimpff, S.C. and Wiernik, P.H.: Antibiotic combination-associated nephrotoxicity in granulocytic patients with cancer. Archives of Internal Medicine 141: 1789–1793 (1981c).

    Article  PubMed  CAS  Google Scholar 

  • Walzer, P.D.; Perl, D.P.; Krogstad, D.J.; Rawson, P.G. and Schultz, M.G.: Pneumocystis carninii pneumonia in the United States: Epidemiologic, diagnostic, and clinical features. Annals of Internal Medicine 80: 83–93 (1974).

    PubMed  CAS  Google Scholar 

  • Webel, M.L.; Ritts, R.E. Jr; Taswell, H.F.; Donadio, J.V. Jr and Woods,, J.E.: Cellular immunity after intravenous administration of methylprednisolone. Journal of Laboratory and Clinical Medicine 83: 383–392(1974).

    PubMed  CAS  Google Scholar 

  • Welling, P.G.; Craig, W.A.; Amidon, G.L. and Kunin, CM.: Pharmacokinetics of cefazolin in normal and uremic subjects.. Clinical Pharmacology and Therapeutics 15: 344–353 (1974).

    PubMed  CAS  Google Scholar 

  • Winston, D.J.; Ho, W.G. and Gale, R.P.: Prophylactic granulocytic tranfusions during chemotherapy of acute leukemia. Annals of Internal Medicine 94: 616–622 (1981).

    PubMed  CAS  Google Scholar 

  • Winston, DJ.; Ho, W.G.; Young, L.S.; Hewitt, W.L. and Gale, R.P.: Piperacillin plus amikacin therapy versus carbenicillin plus amikacin and febrile, granulocytopenic patients. Archives of Internal Medicine 142: 1663–1667(1982).

    Article  PubMed  CAS  Google Scholar 

  • Winston, D.J.; Murphy, W.; Young L.S. and Hewitt, W.L: Piperacillin therapy for serious bacterial infections. American Journal of Medicine 69: 255–261 (1980).

    Article  PubMed  CAS  Google Scholar 

  • Wolfe, M.S.; Armstrong, D.; Louria, D.B. and Blevins, A.: Salmonellosis in patients with neoplastic disease: A review of 100 episodes at Memorial Cancer Center over a 13-year period. Archives of Internal Medicine 128: 546–554 (1971).

    Article  PubMed  CAS  Google Scholar 

  • World Health Organization Scientific Group: Cell-mediated immunity and resistance to infection. World Health Organization Technical Report Series No. 519 (1973).

  • Wright, A.J. and Wilkowske, C.J.: The penicillins. Mayo Clinic Proceedings 58: 21–32 (1983).

    PubMed  CAS  Google Scholar 

  • Young, L.S.: Gram negative sepsis; in Mandell et al. (Eds.) Principles and Practice of Infectious Diseases, pp. 571–608 (John Wiley and Sons, New York 1979).

    Google Scholar 

  • Young, L.S.; Myer-Dudnik, D.V.; Hindler, J. and Martin, W.J.: Aminoglycosides in treatment of bacteremic infections in the immunocompromised host. Journal of Antimicrobial Chemotherapy 8 (Suppl. A): 121–132 (1981).

    Article  PubMed  Google Scholar 

  • Yu. V.L.: Enterococcal superinfection and colonization after therapy with moxalactam, a new broad-spectrum antibiotic. Annals of Internal Medicine 94: 784–785 (1981).

    PubMed  CAS  Google Scholar 

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  1. Microbiology Laboratory and Department of Pharmacy, Brown University, The Memorial Hospital, Pawtucket, Rhode Island, 02860, USA

    Kenneth H. Mayer (Assistant Professor of Medicine) & Olga H. DeTorres

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Mayer, K.H., DeTorres, O.H. Current Guidelines on the Use of Antibacterial Drugs in Patients with Malignancies. Drugs 29, 262–279 (1985). https://doi.org/10.2165/00003495-198529030-00004

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