(Curr. Med. Pract. (1987) : 4, 97)

Prevention of infection in granulocytopaenic patients - a controlled comparison of Septilin with an antibiotic regimen

Suresh Sanchetee, M.D.,
Consultant Physician and Oncologist,
Jodhpur Hospital and Research Centre, Jodhpur, India
(Mrs.) Amit Sanchetee, M.B.,B.S.,
Registrar in Gynaecology and Obstetrics,
S.N. Medical College and Attached Group of Hospitals, Jodhpur, India
and
(Maj.) P.C. Sanchetee, M.D., D.M. (Neurology),
Consultant Physician and Neurophysician,
Military Hospital, New Delhi, India

ABSTRACT

The efficacy of Septilin in granulocytopaenic patients on anti-cancer drug treatment has been compared with the usual antibiotics (cephalosporin and gentamicin) in a controlled study. There was slightly better response with Septilin. Also since Septilin is more economical, non-antibiotic and non-toxic, it could be recommended for adjuvant therapy in these patients.

INTRODUCTION

Septilin (Himalaya) is an indigenous herbal drug. It possesses antibacterial and anti-inflammatory properties. This action is useful in infections of diverse aetiology. The efficacy of Septilin in granulocytopaenic patients on anticancer drug treatment has been compared with a useful antibiotic regimen (cephalosporin and gentamicin) in a controlled study. There were slightly better results with Septilin as regards the response to the two therapeutic regimens.

MATERIAL AND METHODS

Seven males and three females, 5 to 15 years of age, who were diagnosed as suffering from leukaemia or Hodgkin’s lymphoma, were included in this study. Six patients had Hodgkin’s lymphoma and four acute lymphoblastic leukaemia. Tables 1 and 2 indicate the details.

Table 1 : Showing age and sex distribution of the patients
 

Group I (Septilin)

Group II (Antibiotics)

Age in years

Male

Female

Male

Female

5-10

3

2

1

1

11-15

1

-

2

-

Table 2 : Showing the disease status of the patients
 

Group I (Septilin)

Group II (Antibiotics)

Condition

Male

Female

Male

Female
Acute Lymphoblastic Leukaemia

2

1

1

-
Hodgkin’s Lymphoma

2

1

2

1

Six patients were in Group I who received Septilin. There were 7 males in this study.

The patients were divided into two groups. Group I received Septilin, 2 tablets t.i.d. for 7 days and Group II received either cephalosporin and gentamicin or cotrimoxazole for 7 days.

Neither group showed any toxicity to the drugs. Culture swabs from the skin, throat, blood, urine and stool were taken on day 1 of fever and did not show any significant growth.

RESULTS

In the Septilin group 5 patients recovered within 7 days, while only 1 patient recovered in the antibiotic group. All patients showed normal counts within 10 days in Group I while only 2 patients showed recovery of count in Group II (Table 3).

 

Table 3: Showing disappearance of fever and recovery from granulocytopaenia in both the groups
 

Group I (Septilin)
In less than

Group II (Antibiotics)
In less than
 

7 days

7-10 days

10-15 days

7 days

7-10 days

10-15 days
Febrile episode disappearance

5

-

1

1

2

1
Recovery from granulocytopaenia

3

3

-

1

1

2

Recovery from granulocytopaenia was more rapid in the Septilin treated patients (Table 4). They also showed less toxicity than the antibiotic treated group.

Table 4: Showing granulocyte counts in 4 categories

Granulocyte count/mm3

Total

Group I
(Septilin)

Group II
(Antibiotics)
A) 3001-4000

5

3

2
B) 2001-3000

2

1

1
C) 1001-2000

2

2

-

D)

Less than 1000

1

-

1

The maximum number of patients showed a count between 3000-4000/mm3. One patient who had a count of only 300/mm3 was put on antibiotics in Group II.

Evidence from this study indicates that febrile episodes are less frequent with Septilin than with usual antibiotic regimens (Table 5).

Table 5: Showing febrile episodes in the 4 categories
   

Group I(Septilin)
Days

  

Group II (Antibiotics)
Days

(c)

(a)

1

2

3

4

5

6

7

(a)

1

2

3

4

5

6

7

(A)

3

3

1

-

-

1

-

-

2

2

2

2

1

1

2

1

(B)

1

1

-

-

-

-

-

-

1

1

1

-

-

-

1

1

(C)

2

2

2

1

1

1

1

1

-

-

-

-

-

-

-

-

(D)

-

-

-

-

-

-

-

-

1

1

1

1

-

1

1

1
(c) - Category (a) - No. of patients

Patients on Septilin had fewer febrile episodes than those on antibiotics. In Group I (Septilin) only one patient showed persistence of fever, while 3 patients had febrile episodes on day 7 in Group II (Antibiotics).

Thus Septilin has a definite role in the prevention of febrile episodes in granulocytopaenic patients. It is safe and without any toxicity. This being a small study, it is difficult to draw a definite conclusion. However a long-term follow-up is necessary to evaluate the role of Septilin.

ACKNOWLEDGEMENT

We are also highly thankful to Miss. Shellu Sanchetee for her secretarial assistance.

REFERENCES

1.

Pickering, L.K., Anderson, D.C., Chois et al., Leucocyte function in children with malignancy, Cancer (1975) : 35, 1365.

2.

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3.

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4.

Klastersky, J., Weerts, D., Hensgens, C. et al., Fever of unexplained origin in patients with cancer, Am. J. Cancer (1973) : 9, 749.

5.

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