Rossini Fausto, Terruzzi Elisabetta, Verga Luisa, Larocca Alessandra, Marinoni Sara, Miccolis Isabella, Giltri Giuseppe, Isella Manuela, Parma Matteo, Pogliani Enrico M
Hematology Unit, Hospital S. Gerardo, University of Milano Bicocca, Monza, Italy.
Support Care Cancer. 2005 Jun;13(6):387-92. doi: 10.1007/s00520-004-0753-8. Epub 2004 Dec 15.
We compared the efficacy of ceftriaxone (CA regimen) and piperacillin-tazobactam (PTA regimen) in association with amikacin in the treatment of febrile episodes in severely neutropenic hematological patients.
A total of 252 febrile episodes in 224 patients were randomized.
The CA regimen was effective in 62/122 evaluable episodes (50.8%), and the PTA regimen was effective in 64/121 (52.9%; P>0.2). Median time to failure was 4 and 5 days (P>0.1). Further infections developed in 21/122 episodes (17.2%) with the CA regimen and in 12/121 (9.9%) with the PTA regimen (P=0.06). The overall mortality at the end of the febrile episode was 11/243 (4.5%); seven deaths were considered to be related to infection.
Patients treated with piperacillin-tazobactam and amikacin tended to become afebrile sooner and to suffer a lower rate of further infections, even though our data did not show any statistically significant differences between the two groups.
