Piperacillin and gentamicin as non toxic empirical therapy in pediatric patients with fever and neutropenia.

To minimize renal and hematological toxicity during empirical antibiotic therapy for pediatric patients with fever and neutropenia, piperacillin and gentamicin combination therapy was evaluated. Twenty episodes of fever and neutropenia in pediatric patients (less than 20 years old) with malignancies were studied. Elligible patients were defined as having documented fever (temperature greater than 38.5 degrees C) and absolute neutrophil count less than 500/mm3. Antibiotics were continued until neutropenia resolved and clinical response was seen. No bleeding, renal, hematological or other adverse reactions were evident in the cases studied that could be attributed to antibiotic therapy. The organisms recovered were sensitive to one or both antibiotics. There was clinical improvement and bacteriological response in all cases.