External expressions of internal malignancy.

Paraneoplastic conditions are cancer-connected but are not produced as a direct effect of the tumor or metastasis. Some antedate the appearance of the internal malignancy; some run a course parallel to the tumor; some follow a pattern independent of the neoplasm. They occur in a small minority of patients with cancer and are, for the most part, of unknown cause.

In-vitro activity of LY146032 against gram-positive isolates from cancer patients.

The in-vitro activity of LY146032 was compared with that of other antibiotics against Gram-positive organisms, mostly isolated from cancer patients. LY146032 inhibited all isolates, including methicillin-resistant Staphylococcus aureus and Streptococcus faecalis, at a concentration of less than or equal to 2.0 mg/l.

Disseminated Geotrichum candidum infection.

The pathogenicity of the fungus Geotrichum candidum in humans has not been clearly defined. A patient with acute leukemia who developed a fatal disseminated G. candidum infection while neutropenic is described.

Mycobacterium fortuitum bacteremia in patients with cancer and long-term venous catheters.

Primary bacteremia due to Mycobacterium fortuitum is an uncommon occurrence. Four cases of M. fortuitum bacteremia in patients with cancer, one of whom was neutropenic, are presented.

Imipenem/cilastatin therapy of infections in cancer patients.

Imipenem/cilastatin was administered during 153 febrile episodes occurring in cancer patients and the response rate was 68%. Considering only documented infections the response rate was 71%. Patients who received imipenem as initial therapy had a higher response rate than patients who received it after failing other antibiotics (77% versus 68%).

Pseudomonas putida. Newly recognized pathogen in patients with cancer.

Pseudomonas putida was recovered from blood culture specimens between 1980 and 1985 in 15 patients with cancer. No isolates were found in specimens obtained before 1980. Eight patients were considered to have septicemia (more than one positive blood culture result plus clinical signs of infection).

In vitro susceptibility of Citrobacter species to various antimicrobial agents.

The in vitro activities of 16 antimicrobial agents against 14 clinical isolates of Citrobacter diversus and 27 isolates of Citrobacter freundii were studied. C. freundii isolates were more resistant, being susceptible only to amikacin, netilmicin, gentamicin, imipenem, ciprofloxacin, and enoxacin.

Effects of cisplatin-induced nephrotoxicity on gentamicin pharmacokinetics in rats.

The effects of cisplatin-induced nephrotoxicity on the pharmacokinetics of a renally excreted antibiotic, gentamicin, were studied in F-344 rats. A single dose of gentamicin (30 mg/kg, iv) was given to different groups of rats alone, at the same time as, or on day 4, 7, 15, or 29 following cisplatin administration (6 mg/kg, iv). Cisplatin caused a significant decrease in gentamicin clearance and an elevation of gentamicin levels in plasma, kidneys, liver, and spleen at all the time points that were tested except concomitant administration.

In vitro activity of paldimycin (U-70138F) against gram-positive bacteria isolated from patients with cancer.

The in vitro activity of paldimycin, a novel antimicrobial agent, was compared with that of vancomycin against 306 gram-positive isolates (representing 12 bacterial species) obtained from patients with cancer. Paldimycin had lower MICs for 90% of isolates than vancomycin did against most isolates tested. Its activity, however, was medium and pH dependent, being greatest in Nutrient broth at a pH of 6.

Evaluation of high-dose versus standard FAC chemotherapy for advanced breast cancer in protected environment units: a prospective randomized study.

Fifty-nine evaluable patients under 65 years of age with measurable metastatic breast cancer and without prior chemotherapy were randomly assigned to treatment with fluorouracil, Adriamycin (Adria Laboratories, Columbus, OH), and cyclophosphamide (FAC) at standard or high doses (100% to 260% higher than standard FAC) following a dose escalation schedule. Patients randomized to the high-dose FAC received the first three cycles of therapy within a protected environment. Subsequent cycles for this group were administered at standard doses of FAC in an ambulatory setting, the same as for the control group.

Ceftizoxime plus ticarcillin: double beta-lactam therapy for infections in cancer patients.

Eighty-one febrile episodes in cancer patients with adequate neutrophil counts (greater than 1000/microliter) were treated with a double beta-lactam combination of ceftizoxime plus ticarcillin. Fifty-four episodes were microbiologically documented and 27 were clinically documented. The overall response rate was 75% (61 of 81).

Necrotizing dermatitis in patients receiving cancer chemotherapy.

Necrotizing dermatitis in patients being treated with cancer chemotherapeutic agents can be of several types. Microbial causes can include a variety of bacteria and fungi, the most common being Pseudomonas aeruginosa. Gangrene from occlusive causes is not uncommon among cancer patients with coexisting atheromatous, thromboembolic, or obliterative vascular disease.

Treatment of hepatosplenic candidiasis with liposomal-amphotericin B.

Nine patients with hematologic malignancies developed fungal infections, predominantly involving the liver and spleen. Eight patients had biopsy-documented progressive candidiasis and one had an unclassified fungus. The patients were treated with liposomal-amphotericin B (L-AmpB) after their fungal infection progressed during treatment with standard intravenous (IV) AmpB (Fungizone; E.

High-dose induction chemotherapy of metastatic breast cancer in protected environment: a prospective randomized study.

To test the hypothesis of whether high doses of chemotherapy in combination achieve higher response rates and longer durations of response and survival, we treated 33 pre- and perimenopausal patients with good performance status in a prospective trial with escalating doses of fluorouracil, doxorubicin and cyclophosphamide (FAC). Patients were randomly assigned to be treated within a protected environment (laminar air flow room), with prophylactic antibiotics, or in a standard hospital room. Important patient characteristics were equally distributed in the two treatment arms.

In-vitro susceptibility of Pseudomonas species to fifteen antimicrobial agents.

The in-vitro susceptibility of four Pseudomonas spp. (P. aeruginosa, P.

Long-term effects of intravenous hyperalimentation administered during intensive chemotherapy for small cell bronchogenic carcinoma.

Sixty-five patients with small cell bronchogenic carcinoma received their first two of three courses of intensive induction chemotherapy with (30 patients) or without (35 patients) intravenous hyperalimentation (IVH). Patients predominantly had extensive disease (55%), Zubrod's performance status 0 to 2 (63%) and less than or equal to 6% pretreatment weight loss (68%). Both treatment arms were comparable by prognostic factors.

Amphotericin B or ketoconazole therapy of fungal infections in neutropenic cancer patients.

Fungal infections in neutropenic cancer patients have increased in frequency and constitute an important cause of morbidity and mortality. Empiric antifungal therapy is often administered to those patients who have failed to respond to antibacterial antibiotics. We conducted a prospective, randomized trial of amphotericin B and ketoconazole for 172 neutropenic cancer patients with presumed or proven fungal infections.

In vitro evaluation of S-25930 and S-25932, two new quinolones, against aerobic gram-negative isolates from cancer patients.

The in vitro activity of S-25930 and S-25932, two new 4-quinolones, against 450 aerobic gram-negative organisms isolated from cancer patients was evaluated and compared with the activity of ciprofloxacin, enoxacin, difloxacin (A-56619), and A-56620. Both agents inhibited most members of the family Enterobacteriaceae at concentrations of less than or equal to 2.0 micrograms/ml, but their activity against Pseudomonas aeruginosa was inferior to that of other quinolones.

In vitro evaluation of difloxacin (A-56619), A-56620, and other 4-quinolones against isolates from cancer patients.

The in vitro activity of two new quinolones, difloxacin and A-56620, was compared with that of other quinolones against isolates obtained from bacteremic cancer patients. Both agents had a broad antimicrobial spectrum which included both gram-positive and gram-negative organisms. A-56620 had lower MIC values against most organisms tested than difloxacin, and its activity was comparable to that of ciprofloxacin.

Quantitative analysis of the oral complications of antileukemia chemotherapy.

Almost half of 1500 patients (46.9%) treated for acute leukemia developed chemotherapy-related oral infections, oral mucositis, and/or oral hemorrhages at some time during their hospitalization. The frequencies of 34.

Imipenem/cilastatin as secondary therapy for infections in cancer patients.

Imipenem/cilastatin was used to treat 68 documented infections in patients who had failed to respond to other antibiotic regimens. The overall response rate was 68% and was higher among patients in whom the infecting organism could be identified (71% vs. 60%).

In vitro susceptibility of Acinetobacter species to various antimicrobial agents.

The in vitro activity of 18 antimicrobial agents against 40 clinical isolates each of Acinetobacter calcoaceticus subsp. anitratum and Acinetobacter lwoffi was studied. Most of the newer 4-quinolone derivatives were extremely active against these organisms.