Efficacy of the tobramycin - cotrimoxazole - cephalothin combination for febrile episodes in leukemic patients with granulocytopenia

The efficacy of the tobramycin-cotrimoxazole-cephalothin combination (TCC) for febrile episodes in acute leukemic patients in neutropenic phase was investigated. The results in 48 episodes were compared retrospectively with those obtained in 46 febrile episodes in the same type of patients treated with various combinations of antibiotics (VAC regimens). Positive responses were obtained in 79.2% of the episodes treated with TCC compared with 43.5% obtained in the episodes treated with VAC (P<0.025). Excluding the febrile episodes of unknown origin, there were positive responses in 76.9% and in 42.5% of episodes respectively (P<0.01). While in the VAC-treated group a positive response was found to be correlated with the number of circulating neutrophils, there was not such a close correlation in the TCC-treated group. The TXC combination has proved in our experience to be a safe and effective empiric treatment for infective episodes in acute leukemic patients.