Aynur Aynioglu1, Birsen Mutlu, Abdullah Hacihanefioglu. 1. Aynur Aynioglu, Department infectious diseases and clinical microbiology, Zonguldak Ataturk Public Hos-pital, Zonguldak, Turkey. aaynioglu@outlook.com.
Abstract
OBJECTIVE:Empirical antibiotic therapy in neutropenic patients presenting with fever plays a significant role in reducing mortality related to infection. Empirical therapies with broad-spectrum intravenous bactericidal, anti-pseudomonal antibiotics are accepted treatments for febrile neutropenic patients. The aim of this study was to compare the efficacy of piperacillin-tazobactam (PIP-TAZO) and cefoperozone-sulbactam (CS) therapies in adult patients with haematological malignancies presenting with neutropenic fever in a prospective study design. METHODS:Patients with haematological malignancies (leukaemia, lymphoma, multiple myeloma, and myelodysplastic syndrome) were recruited from June 2010-May 2013. Participants were over 18 years old, with an absolute neutrophil count (ANC) of less than 500/mm³ following chemotherapy or expected to have an ANC less than 500/mm³ in the first 48 h post-chemotherapy, and with an oral body temperature ≥ 38.3°C at a single measurement or 38.0°C after 1-h monitoring. Patients were randomised to the two treatment groups. The initial empirical therapy comprised PIP-TAZO (4.5 g/6 h/day, IV) and CS (2 g/8 h/day, IV). RESULTS: The overall success rate was 61% with CS and 49% with PIP-TAZO (p =0.247). Factors affecting the treatment success included a neutrophil count <100/mm3, being in the relapse/refractory stage of malignancy, and the presence of a microbiologically documented infection (p <0.05). CONCLUSIONS:PIP-TAZO and CS monotherapies are equally effective and safe for the empirical treatment of febrile neutropenic patients.
RCT Entities:
OBJECTIVE: Empirical antibiotic therapy in neutropenicpatients presenting with fever plays a significant role in reducing mortality related to infection. Empirical therapies with broad-spectrum intravenous bactericidal, anti-pseudomonal antibiotics are accepted treatments for febrile neutropenicpatients. The aim of this study was to compare the efficacy of piperacillin-tazobactam (PIP-TAZO) and cefoperozone-sulbactam (CS) therapies in adult patients with haematological malignancies presenting with neutropenic fever in a prospective study design. METHODS:Patients with haematological malignancies (leukaemia, lymphoma, multiple myeloma, and myelodysplastic syndrome) were recruited from June 2010-May 2013. Participants were over 18 years old, with an absolute neutrophil count (ANC) of less than 500/mm³ following chemotherapy or expected to have an ANC less than 500/mm³ in the first 48 h post-chemotherapy, and with an oral body temperature ≥ 38.3°C at a single measurement or 38.0°C after 1-h monitoring. Patients were randomised to the two treatment groups. The initial empirical therapy comprised PIP-TAZO (4.5 g/6 h/day, IV) and CS (2 g/8 h/day, IV). RESULTS: The overall success rate was 61% with CS and 49% with PIP-TAZO (p =0.247). Factors affecting the treatment success included a neutrophil count <100/mm3, being in the relapse/refractory stage of malignancy, and the presence of a microbiologically documented infection (p <0.05). CONCLUSIONS:PIP-TAZO and CS monotherapies are equally effective and safe for the empirical treatment of febrile neutropenicpatients.
Authors: M Ponraj; Biswajit Dubashi; B H Harish; S Kayal; S L Cyriac; Jogamaya Pattnaik; K Ranjith; Unni S Pillai; Naresh Jadhav; Kiran K Matta; Jagdeep Singh; Esha Jaffa; Bhanu Prakash Journal: Support Care Cancer Date: 2018-05-17 Impact factor: 3.603