The evaluation of combination therapy of amikacin and imipenem/cilastatin in patients with infections complicating hematological malignancies

• Published in: CHEMOTHERAPY Vol. 40; no. 10; pp. 1286 - 1293
• Main Authors: Yaguchi, Makoto, Kawanishi, Yoshikazu, Tsuboi, Chihiro, Toyama, Keisuke
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Chemotherapy 1992
• Subjects: amikacin; imipenem/ciliastatin
• ISSN: 0009-3165; 1884-5894
• DOI: 10.11250/chemotherapy1953.40.1286

We evaluated the efficacy of amikacin sulfate (AMK) plus imipenem/cilastatin sodium (IPM/CS) in patients with infections complicating hematological malignancies. 1) Forty-two febrile patients (4 septicemia, 35 suspected septicemia and 3 pneumonia) with hematological malignancies (35 cases with acute leukemia, 3 with myelodysplastic syndrome, 2 with malignant lymphoma and 2 with multiple myeloma) were treated intravenously with 400-800mg AMK and 1.5-2.0 g IPM/CS per day. 2) Out of 42 patients, 23 patients including the 4 with septicemia responded to this combination chemotherapy. The overall clinical efficacy rate was 73.8% (31/42). 3) The maximum serum concentration of each drug was 14.8μg/ml for AMK 200 mg i.v., 46.5μg/ml for IPM/CS 1.0 g i.v. and 24.2μg/ml for IPM/CS 0.5 g i.v., These concentrations considerably exceeded the maximum isolated from the 4 patients with septicemia. 4) The efficacy rate in patients with granulocytopenia of less than 100/μEl during therapy, was 61.5% (8/13). 5) The efficacy rate in patients who had a performance status (PS) 0-2 when fever developed was 80.0% (20/25), while it was 64.7% (11/17) in patients of PS 3-4. From the above findings, AMK plus IPM/CS is considered to be a useful antibiotic combination for empirical therapy of infections complicating hematological malignancies.