[Comparative study of piperacillin/tazobactam versus imipenem/cilastatin in febrile neutropenia (1994-1996)].

Abstract

BACKGROUND:

We aimed at comparing the effectiveness and safety of piperacillin/tazobactam(PIP-TAZ) versus imipenem/cilastin (IMI) administered as empiric monotherapy in patients with febrile neutropenia.

PATIENTS AND METHOD:

Patients with hematological diseases who were randomly assigned either PIP-TAZor IMI were enrolled in the study. A sequential strategy of antibiotic therapy addition was applied as long as fever persisted or microorganisms were isolated at 72 h. Moreover, if bacteriologically unconfirmed fever persisted after 5-7 days, an antifungal therapy was started. The treatment was considered successful if fever and clinical signs resolved and/or pathogens were cleared without adding further antibiotics at 72 h. Differences between percentages were analyzed using the *2test.

RESULTS:

137 patients were evaluated. The successful response rate of PIP-TAZ after 72 h was similar to IMI (32.2 and 35.2%). The defervescence time was shorter (3.6 and 4.2 days) and the bacterial response more favourable with PIP-TAZ than with IMI, but statistically significant differences were not reached. The overall response in both groups was 91%.18.2% of episodes were bacteriologically confirmed. The most frequent isolated microorganism was Staphylococcus coagulase-negative(48.8%). There was one only case of septic shock, within the IMI group, and the overall mortality of the group was 8.7%. The occurrence of vomiting in the IMI group was significantly higher than in the PIP-TAZ group (39.9 and 5.6%; p < 0.0001).

CONCLUSIONS:

PIP-TAZ is as effective as IMI and it constitutes a good choice as an initial empiric monotherapy of febrile neutropenia.

• Authors: Figuera A, N Rivero, F Pajuelo, P Font, F Leyra, R de La Cámara, R Arranz, J María Fernández Rañada
• Journal: Medicina clinica (Med Clin (Barc)) Vol. 116 Issue 16 Pg. 610-1 (May 05 2001) ISSN: 0025-7753 [Print] Spain
• Vernacular Title: Estudio comparativo de piperacilina/tazobactam frente a imipenem/cilastatina en la neutropenia febril (1994-1996).
• PMID: 11412645 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Drug Combinations
• Cilastatin
• Piperacillin, Tazobactam Drug Combination
• Imipenem
• Penicillanic Acid
• Cilastatin, Imipenem Drug Combination
• Piperacillin

Topics

• Adolescent
• Adult
• Aged
• Cilastatin (therapeutic use)
• Cilastatin, Imipenem Drug Combination
• Drug Combinations
• Drug Therapy, Combination (therapeutic use)
• Female
• Fever (complications, drug therapy)
• Humans
• Imipenem (therapeutic use)
• Male
• Middle Aged
• Neutropenia (complications, drug therapy)
• Penicillanic Acid (analogs & derivatives, therapeutic use)
• Piperacillin (therapeutic use)
• Piperacillin, Tazobactam Drug Combination