Cefoperazone / sulbactam plus amikacin for empirical therapy of febrile neutropenic patients

Abstract

Purpose: The aim ofthe study was to evalute the effıcacy of cefoperazone-sulbactam plus amikacin for initial therapy of febrile neutropenic patients with hematological malignancies.The overall effıcacy and the need for modifıcations were also determined. Methods: 72 neutropenic patients vith various hematological malignancies who developed 97 febrile episodes vere included in the study. They received cefoperazone 2g-sulbactam Ig every 8h and amikacin 15mg/kg single daily. The study design was in accordance with that described by the Immunocompromised Host Society. Results: 29 episodes were excluded from the study leaving a total of 68 episodes in 50 patients for the evalution. 55% of the febrile episodes were documented as fever of unknown origin. At the initial evaluation 29% of the episodes responded to therapy. At the end of the therapy, success rates vere 49% and 70% without and with modification, respectively. Most of the failures were due to adjustments in therapy accounting for 81% of the failures. Conclusion: This protocol is considered be a successful one with regard to the study population and strict criteria used for assessments. Although frequent modifıcations vere needed to ensure patient survival, the protocol vas effıcacious in preventing early death vithin 72 hours and in improving the outcomes at the end of the therapy.