Clinical Experience with Cefazolin in Large Doses Combined with Aminoglycoside in Blood Disease

The clinical efficacy of cefazolin (8-12g. daily) combined with amin-oglycoside for severe infection was evaluated in 20 patients with blood diseases. In ten of twenty patients, therapeutic success was achieved. Three patients with infection of which the causative organism was not detected responded to cefazolin alone or with gentamicin. But the usual dose of cefazolin (2-4g. daily) was not effective against infections due to gram-negative bacilli in a patient with Hodgkin's disease although there were sufficient neutrophil count. As mixed infection with organisms which were insensitive to cefazolin were frequently observed in patients with neutropenia or malignant blood diseases and most of cefazolin-insensitive organisms were sensitive to aminoglycoside, aminoglycoside should be included in the initial therapy of CEZ in large doses for severe infection due to gram-negative bacilli in these patients. There were no significant side effects except for one case of generalized exanthemas associated with cefazolin ill large dose combined with aminoglycoside.