EVALUATION OF CEFOPERAZONE SULBACTAM FOR EMPIRIC ANTIBIOTIC-THERAPY OF FEBRILE GRANULOCYTOPENIC ADULT CANCER-PATIENTS WITH ACUTE-LEUKEMIA AND LYMPHOMAS

Empiric therapy for febrile granulocytopenic patients is essential but whether monotherapy is as effective as and safer than a combination o f antibacterial agents is still controversial, The use of cefoperazone -sulbactam for treatment of febrile granulocytopenic episodes in adult acute leukemia and lymphoma patients was evaluated in this study, The assessable 32 patients (28 with acute leukemia and 4 with lymphoma) w ere all subjected to clinical and laboratory evaluation, Culture speci mens were obtained from all possible sites of infection before institu tion of antibacterial treatment, Cefoperazone-sulbactam was given empi rically at a dose of 3 g (2 g cefoperazone and 1 g of sulbactam) every 8 hours. Infection was documented in 22 of 32 patients (68.8%) while 10 patients (31.3%) were considered to have fever of unknown origin, M icrobiologic examination of cultures identified a pathogen in 18 patie nts (56.3%); gram-negative organisms were responsible for 8 of these e pisodes (44%), The overall success rate (disappearance of fever and al l signs and symptoms of infection) was 84.4% (27 of 32 patients): 56.3 % of cases (18 of 32) responded to cefoperazone-sulbactam alone and di d not need addition of other agents, while 28.1% (9 of 32) defervesed only after addition of antibacterial (amikacin sulfate 500 mg/12 h) an d/or antifungal agents (amphotericin-B 5 mg/kg/24 h), Cefoperazone-sul bactam failed to control the febrile episodes in 5 (15.6%) of 32 patie nts, Death-related infection occurred in two patients (6.3%), No major toxicities were faced during the treatment, In conclusion, cefoperazo ne-sulbactam, as initial treatment for fever and neutropenia, is an ef fective combination that results in success rates that are comparable with other combinations of antibiotics used for the same indication.