Empirical antibiotic therapy in febrile neutropenic patients with single-daily dose amikacin plus ceftriaxone

Hematologic malignancies and cancer patients who become neutropenic as a result of disease or myelosuppressive cytotoxic therapy are at a high risk of developing life-threatening infections, and hence empirical antibiotic therapy is administered promptly. We investigated once daily regimen of amikacin, for dose-dependent bactericidal activity and post-antibiotic effects, plus ceftriaxone, with a long-half life to maximise time-dependent bactericidal activity. Microbiologically proven septicemia were 11 out of 49 febrile episodes (22.5%) and 10 (91%) of these were due to gram-negative bacilli, mostly Enterobacteriaceae. The overall success of the regimen was 63.3 per cent of patients, with no significant toxicity. In conclusion, our findings suggest that once-daily administration of amikacin plus ceftriaxone in the initial treatment of febrile episodes in neutropenic patients produces satisfactory results and more cost-effective compared with other antibiotic regimens requiring 3-4 doses a day.