[Infections during malignant blood diseases. Value of the carbenicillin-gentamicin combination]

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.