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Sulfamethoxazole-trimethoprim for infections in cancer patients
Abstract:
A combination of sulfamethoxazole and trimethoprim (Bactrim) was given orally to 35 cancer pattients with infections. Thirty-two patients did not respond to an initial antibiotic regimen that consisted primarily of carbenicillin disodium and an aminoglycoside. There were 18 single-organism, Gram-negative infections. The overall cure rate was 54%. The most common infection was pneumonia (47% responded to treatment). Eighty precent of the cases of septicemia were cured. The most common infecting organism was Klebsiella pneumoniae (45% with this infection responded). Eight cases of infection of unknown origin occurred (63% responded to treatment). Overall, 47% of the patients whose neutrophil count remained unchanged or decreased responded, while 61% of those whose neutrophil count remained unchanged or increased responded. There was no close correlation between the minimum inhibitory concentrations and the clinical responses. Sulfamethoxazole-trimethoprim orally is a well tolerated and effective form of antimicrobial therapy.
Insights
Oral sulfamethoxazole-trimethoprim (Bactrim) effectively treated infections in 35 cancer patients, achieving a 54% overall cure rate. This antibiotic combination demonstrated efficacy, particularly in pneumonia and septicemia cases, offering a well-tolerated therapeutic option.
Area of Science:
- Infectious Diseases
- Oncology
- Pharmacology
Background:
- Cancer patients often experience complex infections.
- Standard antibiotic regimens may fail in immunocompromised individuals.
- Alternative antimicrobial therapies are crucial for managing resistant infections.
Purpose of the Study:
- To evaluate the efficacy and tolerability of oral sulfamethoxazole-trimethoprim in cancer patients with infections.
- To assess treatment outcomes in patients refractory to initial antibiotic therapy.
- To identify specific infection types and organisms responsive to sulfamethoxazole-trimethoprim.
Main Methods:
- Oral administration of sulfamethoxazole-trimethoprim to 35 cancer patients with infections.
- Focus on patients who did not respond to prior antibiotic regimens (carbenicillin disodium and aminoglycoside).
- Analysis of cure rates, common infections (pneumonia, septicemia), infecting organisms (Klebsiella pneumoniae), and correlation with neutrophil counts.
Main Results:
- Overall cure rate of 54% observed.
- Pneumonia responded in 47% of cases; septicemia achieved an 80% cure rate.
- Klebsiella pneumoniae was the most common pathogen; infections of unknown origin had a 63% response rate.
Conclusions:
- Oral sulfamethoxazole-trimethoprim is a well-tolerated and effective antimicrobial therapy for cancer patients.
- The drug shows particular promise for treating septicemia and certain Gram-negative infections.
- Clinical response did not strongly correlate with minimum inhibitory concentrations, suggesting complex host-pathogen interactions.