Abstract :
Background: Febrile neutropenia is known to carry a mortality of 15%. Early empirical antibiotics are pivotal to the
management. We compared the efficacy of Piperacillin/Tazobactam (PT group) and Cefoperazone/Sulbactam (CS group)
for early empirical therapy in these patients over a 16-month period. Methods: We studied a total of 133 patients with
febrile neutropenia over a 16-month period. These patients were assigned to either the PT group (n-67) or the CS group(n-
66) and administered standard doses of these drugs (i.e. 4.5 gm, three times a day of PT and 2 gm twice a day of CS). The
two groups were analyzed for various outcomes such as duration of neutropenia, duration of fever and mortality at 30 days.
Results: The average number of patients with fever duration of more than 7 days in the PT group (n=67) was 18 (26.8 %)
and 23 (34.8%) in the CS group (n=66) (p=0.159). 24 patients (35.8%) in the PT group and 21 (31.8%) (p=0.312) patients
in CS group required additional agents such as antifungals or glycopeptides. 9 (13.4%) patients in the PT group and 10
(15.15%) (p=0.388) patients in the CS group died during the course of their illness. Conclusion: There is no statistical
difference between the performance of the combinations of Piperacillin/Tazobactam and Cefoperazone/Sulbactam as
empirical therapy in patients with febrile neutropenia. While the choice of antibiotic in these setting must be made with due
cognizance to local usage, availability and resistance patterns, both these antibiotics form a solid first line of defense in
neutropenia patients with fever
Keyword :
Febrile Neutropenia, Malignancy, Empiric Antibiotic Therapy, Iperacillin/Tazobactam, Efoperazone/Sulbactam.