title: A randomized clinical trial of ceftriaxone and amikacin versus piperacillin tazobactam and amikacin in febrile patients with hematological neoplasia and severe neutropenia.
abstract: OBJECTIVE
  We compared the efficacy of ceftriaxone (CA regimen) and piperacillin-tazobactam (PTA regimen) in association with amikacin in the treatment of febrile episodes in severely neutropenic hematological patients.
  
  
  METHODS
  A total of 252 febrile episodes in 224 patients were randomized.
  
  
  RESULTS
  The CA regimen was effective in 62/122 evaluable episodes (50.8%), and the PTA regimen was effective in 64/121 (52.9%; P>0.2). Median time to failure was 4 and 5 days (P>0.1). Further infections developed in 21/122 episodes (17.2%) with the CA regimen and in 12/121 (9.9%) with the PTA regimen (P=0.06). The overall mortality at the end of the febrile episode was 11/243 (4.5%); seven deaths were considered to be related to infection.
  
  
  CONCLUSIONS
  Patients treated with piperacillin-tazobactam and amikacin tended to become afebrile sooner and to suffer a lower rate of further infections, even though our data did not show any statistically significant differences between the two groups.
authors.affiliation: Hematology Unit, Hospital S. Gerardo, University of Milano Bicocca, Monza, Italy. Fausto.rossini@fastwebnet.it
authors.forename: Fausto
authors.initials: F
authors.lastname: Rossini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Terruzzi
authors.forename: Luisa
authors.initials: L
authors.lastname: Verga
authors.forename: Alessandra
authors.initials: A
authors.lastname: Larocca
authors.forename: Sara
authors.initials: S
authors.lastname: Marinoni
authors.forename: Isabella
authors.initials: I
authors.lastname: Miccolis
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giltri
authors.forename: Manuela
authors.initials: M
authors.lastname: Isella
authors.forename: Matteo
authors.initials: M
authors.lastname: Parma
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Pogliani
mesh_terms: D000328:Adult; D000368:Aged; D000583:Amikacin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000188:drug therapy* / Q000209:etiology; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D002443:Ceftriaxone; D000583:Amikacin; D010397:Penicillanic Acid; D010878:Piperacillin