A comparative study of imipenem versus piperacillin plus gentamicin in the initial management of febrile neutropenic patients with haematological malignancies

Three-hundred and twelve episodes of fever in 234 neutropenic patients with haematological malignancies were treated empirically with either imipenem or a combination of piperacillin and gentamicin. There were no significant differences in the percentages of patients responding to therapy at either...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 1992-12, Vol.30 (6), p.843-854
Main Authors: Leyland, M. J., Bayston, K. F., Cohen, J., Warren, R., Newland, A. C., Bint, A. J., Cefai, C., White, D. G., Murray, S. A., Bareford, D., Deaney, N. B.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Drug Therapy, Combination - therapeutic use
Fever - drug therapy
Fever - etiology
Fever - microbiology
Gentamicins - therapeutic use
Humans
Imipenem - therapeutic use
Leukemia - complications
Lymphoma - complications
Medical sciences
Middle Aged
Neutropenia - complications
Neutropenia - etiology
Pharmacology. Drug treatments
Piperacillin - therapeutic use
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Summary:Three-hundred and twelve episodes of fever in 234 neutropenic patients with haematological malignancies were treated empirically with either imipenem or a combination of piperacillin and gentamicin. There were no significant differences in the percentages of patients responding to therapy at either 72 h (59% and 56% of assessable episodes in the imipenem and combination groups respectively) or at the end of treatment (55% and 53% of assessable episodes in the imipenem and combination groups respectively). Patients in the piperacillin plus gentamicin group experienced significantly more renal tubular damage whereas those who received imipenem suffered more nausea or vomiting. We conclude that imipenem mono-therapy represents an acceptable alternative to piperacillin plus gentamicin as empirical therapy of the febrile neutropenic patient.
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/30.6.843