Combination Therapy Data

An early study by Hilf suggested that combination therapy was superior to monotherapy in patients with Pseudomonas bacteremia BUT 84% of monotherapy patients received inadequate monotherapy with an aminoglycoside.

Five more recent studies have not shown a difference in mortality when patients received appropriate monotherapy for Pseudomonas bacteremia.

Recent prospective studies have not shown a benefit to combination therapy over monotherapy in the treatment of serious Gram-negative infections in both nonneutropenic AND neutropenic patients.

Two recent meta-analysis showed no difference in outcomes of patients with sepsis or febrile neutropenia treated with beta-lactams alone vs beta-lactam/aminoglycoside combinations although patients in the latter group had a higher incidence of nephrotoxicity.