COMPARING TWO EMPIRIC ANTIBIOTIC REGIMENS IN TREATMENT OF FEBRILE NEUTROPENIC CANCER PATIENTS

Since patients with hematologic malignancies and some solid tumors have prolonged periods of severe neutropenia due to the disease itself or its intensive chemotherapy, they often develop life-threatening infections which can be controlled by using appropriate empiric antibiotic regimens. The variety and combination of antibiotics is to the extent that a more common one can be replaced by the others. Therefore, this study was conducted to investigate whether a regimen like Piperacillin and Amikacin could be as useful as a routine regimen such as Ceftazidime and Amikacin or not. In a randomized multicenter clinical trial, 73 patients were randomly treated by two different regimens. The first group(37 patients) was treated with Ceftazidime (2gr/TDS/IV) plus Amikacin (15 mgr/kg/IV infusion daily) and the second group (36 patients) with Piperacillin (4gr/q4 hr/IV) plus Amikacin. Becoming afebrile in 48 or 72 hours after beginning antibiotic regimen was the response criterion to treatment. 27 patients(73%) in the first and 23(63.9%) in the second group responded to the treatment. Statistically, there was no significant difference between the responses to treatment in both groups. As a whole, 50 out of 73 patients (68.5%) responded to our initial treatment and the two regimens were statistically & equally effective. So we recommend that the combination of Piperacillin plus Amikacin can also be used as a suitable treatment in febrile neutropenic cancer patients in our country.