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.
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