Razi Journal of Medical Sciences

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Since patients with hematologic malignancies and some solid tumors have prolonged periods of severe neutropenia due to the disease itself or its intensive chemotherapy, they often develop life-threatening infections which can be controlled by using appropriate empiric antibiotic regimens. The variety and combination of antibiotics is to the extent that a more common one can be replaced by the others. Therefore, this study was conducted to investigate whether a regimen like Piperacillin and Amikacin could be as useful as a routine regimen such as Ceftazidime and Amikacin or not. In a randomized multicenter clinical trial, 73 patients were randomly treated by two different regimens. The first group(37 patients) was treated with Ceftazidime (2gr/TDS/IV) plus Amikacin (15 mgr/kg/IV infusion daily) and the second group (36 patients) with Piperacillin (4gr/q4 hr/IV) plus Amikacin. Becoming afebrile in 48 or 72 hours after beginning antibiotic regimen was the response criterion to treatment. 27 patients(73%) in the first and 23(63.9%) in the second group responded to the treatment. Statistically, there was no significant difference between the responses to treatment in both groups. As a whole, 50 out of 73 patients (68.5%) responded to our initial treatment and the two regimens were statistically & equally effective. So we recommend that the combination of Piperacillin plus Amikacin can also be used as a suitable treatment in febrile neutropenic cancer patients in our country.

Keywords: Key Words: 1) Fever and neutropenia 2) Piperacillin 3) Ceftazidime 4) Amikacin

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