A study of the efficacy and safety of cefodizime (CDZM) and gentamicin (GM) combination therapy in severe infections associated with hematologic disorders

The efficacy and safety of cefodizime (CDZM) and gentamicin (GM) combination therapy in severe infections associated with hematologic disorders was studied by the Tokai Infection Study Group on Hematological Disorders. Subjects chosen for this study were 151 patients with underlying hematologic disorders, who were treated between the months of September 1991 to September 1992. These subjects were diagnosed as having severe infections which required antibiotic therapy. Basically, CDZM was administrated by drip infusion at a dose of 4 g/day for a minimum of three days, while 120 mg/day of GM was simultaneously administrated in the same manner, half the dose being given in the morning and half in the evening. Of the 151 patients initially chosen for study, 12 were deemed ineligible, leaving 139 patients for clinical evaluation. Response to the therapy was excellent in 42 patients and good in 35, indicating that therapy was effective in 55.4% of cases (77/139). Antibacteriological effectiveness was also high, with a response rate of 44.4% in gram-negative and 71.4% in gram-positive bacteria. In cases where the pathogenic bacteria could not be identified, the mean response rate was 55.9%. When neutrophil counts before treatment was <100/μl, the response rate was 54%; at 100-499/μl, the response rate was 50%, and >500/μl, 54.2%. The incidence of side effects and abnormal laboratory findings was very low: 1.3% and 0.7% respectively. From the above findings, we concluded that combination therapy with CDZM and GM is a highly useful treatment for severe infection associated with hematologic diseases.