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A Randomized Prospective Multicentre Trial of Cefpirome Versus Piperacillin-Tazobactam in Febrile Neutropenia
| Content Provider | Scilit |
|---|---|
| Author | Bauduer, Frédéri Cousin, Thierry Boulat, Olivier Rigal-Huguet, Françoise Molina, Lysiane Fegueux, Nathalie Jourdan, Eric Boiron, Jean-Michel Reiffers, Josy |
| Copyright Year | 2001 |
| Abstract | Fever is frequently the only clinical sign of infection in patients with chemo-induced neutropenia. In this setting, empirical administration of broad spectrum antibiotics must be rapid. The aim of this work was to compare, for the first time, cefpirome (CPO) and piperacillin-tazobactam (FT) in a large randomized trial. Two hundred-eight febrile neutropenic episodes (FNE) (≥ 38,5°C and ANC < 0.5 giga/1) were treated by randomization, as first line therapy, using either CPO 2 g × 2/day (105 cases) or FT 4 g × 3/day (103 cases), alone (CPO: 15/PT: 15), or plus aminoglycoside (165 cases, CPO: 82/PT: 83) or quinolone (CPO: 2/PT: 2). There were 131 men and 77 women aged between 17 and 83 years (median: 49) who received chemotherapy (n=160) or allogeneic (n=10) or autologous (n=38) stem cell transplantations. Underlying diseases were: acute leukemia (n=131), lymphoma (n=33), myeloma (n=16), solid tumor (n=8), myeloproliferative disorder (n=9), chronic lymphoid leukemia (n=5), aplastic anemia (n=3), myelodysplasia (n=3). Distribution of age, neutropenia duration (median: 17 days), underlying disease, and protocol therapy duration (median: 11 days) was comparable in both arms. A rnicrobiologically documented infection (MDI) was evidenced in 57 cases (27%). Bacteria were isolated from blood cultures in 54 cases (Gram positive: 32 cases). Their in vitro susceptibility rates to CPO and FT were not different. Two days after antibiotics initiation, clinical (fever disappearance) and microbiological (culture negativation) success rates (SR) were 62% for CPO versus 61% for FT and 50% versus 55% respectively in case of MDI (p = 0.89). Two deaths and 77 failures were registered. At the end of protocol, SR (no antibiotic change/absence of superinfection) was 59% with CPO versus 50% with FT (p = 0.27) and 53% versus 40% respectively in the 151 cases with neutropenia ≥ 10 days (p = 0.17). The occurrence of side effects was similar in both arms. In our hands, the efficacy of CPO and FT was comparable for treating FNE. |
| Related Links | https://www.tandfonline.com/doi/pdf/10.3109/10428190109064594 |
| Ending Page | 386 |
| Page Count | 8 |
| Starting Page | 379 |
| ISSN | 10428194 |
| e-ISSN | 10292403 |
| DOI | 10.3109/10428190109064594 |
| Journal | Leukemia & Lymphoma |
| Issue Number | 3 |
| Volume Number | 42 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2001-01-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Leukemia & Lymphoma Pharmacology and Pharmacy Neutropenic Fever Cefpirome Piperacillin-tazobactam Randomized Trial |
| Content Type | Text |
| Resource Type | Article |
| Subject | Hematology Cancer Research Oncology |
