Piperacillin/tazobactam vs. cefoperazone/sulbactam in adult low-risk febrile neutropenia cases

Summary Aim The aim of this study was to compare the efficacy of piperacillin/tazobactam (P/T) and cefoperazone/sulbactam (C/S) in the empirical treatment of adult neutropenic fever. Methods Data and outcomes of low‐risk adult cases with neutropenic fever and treated with P/T (4.5 g q6h) or C/S (2 g q8h) between 2005 and 2011 June were extracted from our database. Risk evaluation was made according to criteria of Multinational Association for Supportive Care in Cancer (MASCC) and a score of ≥ 21 was considered as low risk. Data were collected prospectively by daily visits and evaluated retrospectively. Primary outcome was – fever defervescence at 72 h in combination with success without modification (referring to episodes where the patient recovered from fever with disappearance of signs of infection without modification to initial empirical treatment). All‐cause mortality referred to death resulting from a documented or presumed infection or unidentified reason during the treatment and 30‐day follow‐up period. Results A total of 172 patients (113 cases P/T and 59 cases C/S) fulfilled the study inclusion criteria. Persistent response in P/T arm was 73.5%, whereas it was 64.5% in C/S arm (p > 0.05). Rates of any modification were also similar in both treatment arms. All‐cause mortality during the treatment and 30‐day follow‐up period was not significantly different (P/T: 4/113 vs. C/S: 2/59, p > 0.05). There was no severe adverse effect requiring antibiotic cessation in both cohorts. Conclusion In conclusion, our data suggest that C/S may be a safe alternative to P/T in the empirical treatment of adult low‐risk febrile neutropenia cases.