Disclosure SU, BA and HP received speaker's honorarium from Pfizer.
Article first published online: 22 DEC 2013
© 2013 John Wiley & Sons Ltd
International Journal of Clinical Practice
Volume 68, Issue 2, pages 230–235, February 2014
How to Cite
Sipahi, O. R., Arda, B., Nazli-Zeka, A., Pullukcu, H., Tasbakan, M., Yamazhan, T., Ozkoren-Calik, S., Sipahi, H. and Ulusoy, S. (2014), Piperacillin/tazobactam vs. cefoperazone/sulbactam in adult low-risk febrile neutropenia cases. International Journal of Clinical Practice, 68: 230–235. doi: 10.1111/ijcp.12279
- Issue published online: 26 JAN 2014
- Article first published online: 22 DEC 2013
- Manuscript Accepted: 8 AUG 2013
- Manuscript Received: 16 APR 2013
The aim of this study was to compare the efficacy of piperacillin/tazobactam (P/T) and cefoperazone/sulbactam (C/S) in the empirical treatment of adult neutropenic fever.
Data and outcomes of low-risk adult cases with neutropenic fever and treated with P/T (4.5 g q6h) or C/S (2 g q8h) between 2005 and 2011 June were extracted from our database. Risk evaluation was made according to criteria of Multinational Association for Supportive Care in Cancer (MASCC) and a score of ≥ 21 was considered as low risk. Data were collected prospectively by daily visits and evaluated retrospectively. Primary outcome was – fever defervescence at 72 h in combination with success without modification (referring to episodes where the patient recovered from fever with disappearance of signs of infection without modification to initial empirical treatment). All-cause mortality referred to death resulting from a documented or presumed infection or unidentified reason during the treatment and 30-day follow-up period.
A total of 172 patients (113 cases P/T and 59 cases C/S) fulfilled the study inclusion criteria. Persistent response in P/T arm was 73.5%, whereas it was 64.5% in C/S arm (p > 0.05). Rates of any modification were also similar in both treatment arms. All-cause mortality during the treatment and 30-day follow-up period was not significantly different (P/T: 4/113 vs. C/S: 2/59, p > 0.05). There was no severe adverse effect requiring antibiotic cessation in both cohorts.
In conclusion, our data suggest that C/S may be a safe alternative to P/T in the empirical treatment of adult low-risk febrile neutropenia cases.