Penicillin or vancomycin plus ceftazidime in febrile neutropenic patients after stem cell transplantation

The response of gram-positive cocci to third generation cephalosporin thera py in febrile neutropenic patients is not optimal. We evaluated the safety and efficacy of ceftazidime plus penicillin (C+P) and compared it to ceftaz idime plus vancomycin (C+V) in febrile neutropenic patients. The study incl udes 64 patients admitted to the Department of Haematology. Thirty-six pati ents were treated with C+V and 28 patients with C+P. Control of infection w as observed in 78% of the patients in the C+V group and in 57% of the patie nts in C+P group (p = 0.5). Infection was the cause of the death of 1 patie nt in each group. We conclude that the combination of C+P has the same acti vity as the combination of C+V in febrile neutropenic patients. The morbidi ty and mortality were identical in both groups but cost effectiveness was i n favour of the C+P group.