The role of the new penicillins and cephalosporins in the management of infection in granulocytopenic patients.

Overall, the use of the new cephalosporins has not so far been a major breakthrough in the empire therapy of febrile episodes and infections in granulocytopenic patients. In the only controlled large study available so far (EORTC), the cefotaxime-containing regimen was definitely not the best among the combinations tested. It remains to be seen whether other cephalosporins such as cefoperazone or ceftazidime would perform better in the future; especially with ceftazidime alone or in combination with aminoglycosides, the early results appear to be very promising. Whether single drug therapy with one of these new cephalosporins, which usually results in a high serum bactericidal activity, will eventually prove to be as good as combination therapy will await evaluation of more patients over extended periods of time, with a special attention to the possible emergence of resistant pathogens.