Is piperacilline/tazobactam effective as carbapenem in empirical antimicrobial treatment of febrile neutropenia?


DEMİRASLAN H., Metan G., KAYNAR L., ALP MEŞE E. , DOĞANAY M.

The 7th Eurasia Congress of Infectious Diseases, Tiflis, Georgia, 30 September - 03 October 2015, vol.42, pp.150

  • Publication Type: Conference Paper / Full Text
  • Volume: 42
  • City: Tiflis
  • Country: Georgia
  • Page Numbers: pp.150

Abstract

In patients given cancer chemotherapy, febrile neutropenia is main problem, and sources of infection cannot be found in many times. Resistant bacterial infections may lead high mortality. This study is presented on effectiveness of empirical antimicrobial
treatment which is piperacillin-tazobactam versus carbapenem, and effects on mortality of the patients. This study was made using records of Infection Control Committee in Erciyes University. The patients older than 18-year old were included who admitted in first 3 months of 2014 and 2015 years. The patients who have any diagnosis other than gram negative bacterial infection, only Gram positive infections, only invasive fungal infections were excluded. Of all 101 patients with febrile neutropenia, 37 in year 2104 and 64 in 2015 were included the study. Diagnosis of the patients were acute leukemia in 65, lymphoma in 16, multiple myeloma in 11, myelodisplastic syndrome in 5 and others in 4 including chronic myeloid leukemia, aplastic anemia and testis tumor. Of the patients, 39.6% was growth of any Gram negative bacteria in their samples. The hospitalized patients in year 2014 had statistically the longer length of stay (28.3 vs. 18.5 days), and treatment period (10.8 vs. 8.0 days), but they had higher Charlson’ score (2.51 vs. 2.12) than in year 2015. Although TZP usage rate in 2015
was statistically the higher (81.0%), carbapenem usage rate in 2014 was the higher (89.2%) than other antimicrobials (p=0.001).
Susceptibility rate of ciprofloxacin was higher (75.0% vs. 33.3%) in 2015 than that in 2014 (p=0.010). 14-day mortality rate was statistically higher (18.9% vs. 4.7%) in year 2014 than those in year 2015 (p=0.027).
In conclusion, it was found that mortality rate with piperacillin/tazobactam was not higher than those with carbapenem. TZP is still useful regimen in the empirical treatment of febrile neutropenia.