Imipenem versus piperacillin/tazobactam for empiric treatment of neutropenic fever in adults

Intern Med J. 2013 Oct;43(10):1151-4. doi: 10.1111/imj.12226.

Abstract

Australian guidelines for neutropenic fever recommend piperacillin/tazobactam (PIP-TAZ) or cefepime for first-line empiric treatment of neutropenic fever. We compared outcomes among haematology patients before and after changing our first-line neutropenic fever treatment from imipenem to PIP-TAZ. Forty-five patients received imipenem and 60 PIP-TAZ. Despite a higher rate of antibiotic modification in the PIP-TAZ cohort, treatment success and time to defervescence were similar, with a trend towards fewer Clostridium difficile infections in the PIP-TAZ cohort.

Keywords: imipenem; neutropenia; piperacillin; sepsis; tazobactam.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage*
  • Cohort Studies
  • Drug Substitution / methods*
  • Female
  • Fever / diagnosis
  • Fever / drug therapy*
  • Humans
  • Imipenem / administration & dosage*
  • Male
  • Middle Aged
  • Neutropenia / diagnosis
  • Neutropenia / drug therapy*
  • Penicillanic Acid / administration & dosage
  • Penicillanic Acid / analogs & derivatives*
  • Piperacillin / administration & dosage
  • Piperacillin, Tazobactam Drug Combination
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Piperacillin, Tazobactam Drug Combination
  • Imipenem
  • Penicillanic Acid
  • Piperacillin