Korean J Intern Med.  1999 Jul;14(2):15-19.

Imipenem-cilastatin versus sulbactam-cefoperazone plus amikacin in the initial treatment of febrile neutropenic cancer patients

• Ozyilkan O
• Yalcintas
• Baskan S

Abstract

The treatment of infectious complications in cancer patients has evolved as a consequence of the developments in the chemotherapy of cancer patients. In this prospective, randomized study, we compared imipenem-cilastatin and sulbactam-cefoperazone with amikacin in the empiric therapy of febrile neutropenic (< 1000/mm3) patients with liquids and solid tumours. Of 30 evaluable episodes, 15 were treated with imipenem-cilastatin and 15 were treated with sulbactam-cefoperazone plus amikacin. 73% of episodes were culture-positive: gram-positive pathogens accounted for 62% of the isolates. Bacteremia was the most frequent site of infection. The initial clinical response rate for both regimens was 60% (p > 0.05). No major adverse effects occurred. This study demonstrated that imipenem-cilastatin monotherapy and combination therapy of sulbactam-cefoperazone plus amikacin were equally effective empiric therapy for febrile granulocytopenic cancer patients.

Keyword

Imipenem-Cilastatin; Sulbactam-Cefoperazone; Amikacin; Neutropenic fever

MeSH Terms

Adolescence
Adult
Aged
Aged, 80 and over
Amikacin/therapeutic use
Antibiotics, Combined/therapeutic use*
Bacteremia/drug therapy
Bacteremia/complications
Cefoperazone/therapeutic use
Cilastatin/therapeutic use
Female
Fever/drug therapy*
Fever/complications
Human
Imipenem/therapeutic use
Male
Middle Age
Neoplasms/drug therapy*
Neoplasms/complications
Neutropenia/drug therapy*
Neutropenia/complications
Prospective Studies
Sulbactam/therapeutic use