Phlebitis related to
antibiotic infusion is one of the most frequent causes of morbidity in the debilitated patients with severe
infection. There are a number of causes of infusion-induced
phlebitis such as pH of intravenous fluid, needle used, and contamination of venipuncture site. Vein used to play an important role, particularly in patients with
granulocytopenia receiving
intravenous infusion.
Cephalothin is an effective
antibiotic in the treatment of granulocytopenic
infection and is widely used currently. When
cephalothin was introduced commercially, the frequency of
phlebitis was as high as 50%. The main reason was thought to be acidity of the
antibiotic solution. The
cephalothin solution used currently is neutral in pH, but prevention of
phlebitis is still not perfect. In contrast,
cephapirin recently developed
cephalosporin antibiotic, which resembles
cephalothin in the antimicrobial activity and pharmacological properties caused less
phlebitis than
cephalothin in initial clinical studies. The patients receiving
chemotherapy for malignant diseases frequently die of
infections. A
cephalosporin antibiotic is administered intravenously for a prolonged time in the presence of
thrombocytopenia, and under such circumstances, other
antibiotics such as
carbenicillin (CBPC) and
aminoglycoside are usually used in combination. The influence of these
antibiotics injected through the same vein must be considered, but the possibility of
phlebitis due to CBPC and
aminoglycoside is negligible. In the present clinical study, 24 granulocytopenic patients were treated with the combination of
antibiotics,
cephapirin-
carbenicillin-
amikacin and
cephalothin-
carbenicillin-
amikacin. Besides the clinical effect of the
antibiotics, the incidence and severity of
phlebitis were studied.