Sixty-four severe
infections in hospitalized patients were treated with intravenous
Timentin. Most patients (mean age: 50.5 years, range 18-85) had serious underlying conditions such as
agranulocytosis,
heart failure,
cancer,
diabetes mellitus, chronic
alcoholism or other functional or anatomical abnormalities. Forty-three episodes were bacteriologically proved, and bacteraemia was diagnosed in 18. The sites of
infection were: lower respiratory tract (10), upper respiratory tract (10), soft tissues (9), urinary tract (7), bones (6), peritoneal cavity (3), meninges (1) and pelvis (1). In addition, 13 episodes of
fever and four of septicaemia in patients with
agranulocytosis were treated with
Timentin plus
amikacin. Overall, 59% of the episodes were cured, 14% improved and 17% failed to respond. In 9% of cases the efficacy of the
Timentin was unassessable mainly because of concurrent administration of other antimicrobials. Failure appeared to be more frequent in soft tissue and
intra-abdominal infections, in patients infected with bacteria susceptible to
Timentin but resistant to
ticarcillin and in patients superinfected with
Timentin-resistant strains. Major side effects were haemorrhagic
diathesis with platelet dysfunction (1), severe water
sodium overload (1), and possibly
pancreatitis (1). Other side effects were mild:
catheter-related
phlebitis, and abnormal but clinically insignificant laboratory test results.
Timentin appears to be an effective and safe broad-spectrum combination which compares favourably with
third-generation cephalosporins in the treatment of severe
hospital infections. More experience is needed to decide whether the somewhat lower response rate in patients infected with
ticarcillin-resistant strains is significant.