title: [Efficacy and safety of piperacillin-tazobactam for febrile neutropenic patients in Japan].
abstract: The IDSA guideline for management of febrile neutropenic patients updated in 2010 recommends monotherapy with anti-pseudomonal-lactam agents, including piperacillin-tazobactam (PIPC/TAZ) for high-risk patients. However, clinical studies of PIPC/TAZ are limited in Japanese patients. In this study, we conducted an open-labeled non-randomized prospective trial to examine the efficacy and safety of PIPC/TAZ as an empirical treatment for Japanese patients with febrile neutropenia. Forty-nine febrile episodes in neutropenic patients excluding those undergoing allogeneic stem cell transplantation (high risk 36, low risk 13) were analyzed. The overall response rate was 71%, and no significant differences between the high-risk and the low-risk group were observed (high risk 72%, low risk 69%). Neither PS nor usage of G-CSF affected the response rate. No major side effects were observed in the study. The efficacy and the safety profile of PIPC/TAZ treatment were comparable to those in other previous Western studies. In conclusion, this study suggests PIPC/TAZ is effective and well tolerated as an initial empirical treatment for febrile neutropenic Japanese patients.
authors.affiliation: Department of Hematology, Kitasato University School of Medicine.
authors.forename: Koji
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kamata
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kimura
authors.forename: Sosei
authors.initials: S
authors.lastname: Okina
authors.forename: Ryuji
authors.initials: R
authors.lastname: Ishii
authors.forename: Manabu
authors.initials: M
authors.lastname: Osaka
authors.forename: Mikio
authors.initials: M
authors.lastname: Danbara
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Horie
authors.forename: Masaaki
authors.initials: M
authors.lastname: Higashihara
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000188:drug therapy* / Q000209:etiology; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D010878:Piperacillin / Q000008:administration & dosage / Q000009:adverse effects; D000077725:Piperacillin, Tazobactam Drug Combination; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D010878:Piperacillin