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A randomized clinical trial of ceftriaxone and amikacin versus piperacillin tazobactam and amikacin in febrile patients with hematological neoplasia and severe neutropenia.

Author(s): Rossini F, Terruzzi E, Verga L, Larocca A, Marinoni S, Miccolis I, Giltri G, Isella M, Parma M, Pogliani EM

Affiliation(s): Hematology Unit, Hospital S. Gerardo, University of Milano Bicocca, Monza, Italy. Fausto.rossini@fastwebnet.it

Publication date & source: 2005-06, Support Care Cancer., 13(6):387-92. Epub 2004 Dec 15.

Publication type: Clinical Trial; Randomized Controlled Trial

GOAL OF WORK: We compared the efficacy of ceftriaxone (CA regimen) and piperacillin-tazobactam (PTA regimen) in association with amikacin in the treatment of febrile episodes in severely neutropenic hematological patients. PATIENTS AND METHODS: A total of 252 febrile episodes in 224 patients were randomized. MAIN RESULTS: The CA regimen was effective in 62/122 evaluable episodes (50.8%), and the PTA regimen was effective in 64/121 (52.9%; P>0.2). Median time to failure was 4 and 5 days (P>0.1). Further infections developed in 21/122 episodes (17.2%) with the CA regimen and in 12/121 (9.9%) with the PTA regimen (P=0.06). The overall mortality at the end of the febrile episode was 11/243 (4.5%); seven deaths were considered to be related to infection. CONCLUSIONS: Patients treated with piperacillin-tazobactam and amikacin tended to become afebrile sooner and to suffer a lower rate of further infections, even though our data did not show any statistically significant differences between the two groups.

Page last updated: 2006-01-31

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