Ceftizoxime plus ticarcillin: double β-lactam therapy for infections in cancer patients

• Published in: Journal of antimicrobial chemotherapy 1987-03, Vol.19 (3), p.367-371
• Main Authors: Rolston, Kenneth V. I., Jones, Paula G., Fainstein, Victor, Elting, Linda, Bodey, Gerald P.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial Infections - complications; Bacterial Infections - drug therapy; Biological and medical sciences; Cefotaxime - analogs & derivatives; Cefotaxime - therapeutic use; Ceftizoxime; Drug Therapy, Combination; Female; Fever; Gram-Negative Bacteria - drug effects; Gram-Positive Bacteria - drug effects; Humans; Male; Medical sciences; Middle Aged; Neoplasms - complications; Penicillins - therapeutic use; Pharmacology. Drug treatments; Pneumonia - complications; Pneumonia - drug therapy; Sepsis - complications; Sepsis - drug therapy; Ticarcillin - therapeutic use
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/19.3.367

Eighty-one febrile episodes in cancer patients with adequate neutrophil counts (> 1000/μl) were treated with a double β-lactam combination of ceftizoxime plus ticarcillin. Fifty-four episodes were microbiologically documented and 27 were clinically documented. The overall response rate was 75% (61 of 81). The response rate in 38 episodes where a single organism was identified was 71%. Polymicrobial infections were associated with a high response rate of 87%. Responses occurred in six of eight Gram-positive and 21 of 30 Gram-negative infections. Pneumonia was the most frequent infection and was associated with a response of 61%. Septicaemia and urinary tract infections also occurred commonly and had response rates of 76% and 89% respectively. All but one organism were susceptible to at least one of the antibiotics. No resistant organisms emerged during therapy. Side-effects included rash (1), phlebitis (3), and coagulation abnormalities without bleeding (3). Four patients developed superinfections (three bacterial, one fungal). The double β-lactam combination of ceftizoxime plus ticarcillin was safe and effective therapy for infections in non-neutropenic cancer patients.