14

Imipenem/cilastatin equals cefoperazone + mezlocillin in febrile patients with cancer and neutropenia

Empiric I • •• imipenem/cilastatin was as effective as the double beta-Iactam combination of cefoperatone and metlocillin for initial response, as well as survival through the neutropenic episode' in a randomised study conducted in 131 febrile patients with cancer and neutropenia. The proportion of episodes in which fever defervesced within 72 hours was similar in both treatment groups (51 % in the cefoperazone + mezlocillin group vs 59% in the imipenem/cilastatin group). Survival was similar in patients who received cefoperazone + mezlocillin (89%) or imipenem/cilastatin (90%).

71 febrile episodes occurring during a period of neutropenia were treated with IV cefoperazone 2g bid + IV mezlocillin 4g qid, and 83 episodes were treated with IV imipenem/cilastatin 500mg qid. Antibacterial therapy was unaltered in 54% of episodes treated with cefoperazone + mezlocillin and 52% of episodes treated with imipenem/cilastatin and there was no significant between-group difference in the addition of antifungal or antiviral agents to either antibacterial regimen.

Rash and diarrhoea occurred with equal frequency in both treatment groups but imipenem/cilastatin was associated with nausea in 25% of cases. Mortimer JE, Black DW, Fijalka S. Comparison of cefoperazone and mezlocillin with imipenem/cilastatin in febrile, neutropenic patients with cancer. Current Therapeutic Research 49: 701-710, Apr 1991 7072

20 Jul 1991 INPHARMA® ISSN 0156-2703/91/0720-0014/0$01.00/0 cAdis International Ltd