Tobramycin and ticarcillin as empiric therapy for febrile patients with granulocytopenia: a reevaluation.

The combination of tobramycin and ticarcillin is an established regimen used to empirically treat patients with granulocytopenia and fever. However, the clinician now has a plethora of newer alternative antibiotic combinations from which to choose. In this retrospective study of 25 granulocytopenic patients recently treated with tobramycin and ticarcillin, a combined favorable or partial response rate of 78% was achieved, without loss of efficacy over time as a result of emerging resistance of organisms. Our reevaluation of this antibiotic regimen emphasizes that it continues to be as efficacious and safe as newer antibiotic combinations, and supports its continued use until a newer regimen is shown to have significant advantages. This study also emphasizes the significance of staphylococci as pathogens in granulocytopenia, and suggests the need to add specific antistaphylococcal coverage whenever catheter-related infection is suspected.