Management of bacterial infections in severely neutropenic subjects

The safety and efficacy of tobramycin, a new aminoglycoside, have been evaluated in combination antibiotic therapy in 49 episodes of infection in 25 neutropenic patients. Tobramycin was used in combination with a cephalosporin in 40 episodes and with carbenicillin in 6. The most common infections were respiratory (21 episodes) and septicaemic (16 episodes). One or more pathogens were identified in 38 episodes, of which 36 were due to Gram-negative organisms. The clinical response was satisfactory in 71% of episodes, and the pathogens were eliminated in 50% of episodes in which follow-up bacteriological investigation was available. No renal, auditory, or vestibular toxicity was observed.