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Papers by Hakan ÇELEBİ
Japanese Journal of Clinical Oncology, 2010
Objective: Empirical beta-lactam monotherapy has become the standard therapy in febrile neutropen... more Objective: Empirical beta-lactam monotherapy has become the standard therapy in febrile neutropenia. The aim of this study was to compare the efficacy and safety of piperacillintazobactam versus carbapenem therapy with or without amikacin in adult patients with febrile neutropenia. Methods: In this prospective, open, single-center study, 127 episodes were randomized to receive either piperacillin -tazobactam (4 Â 4.5 g IV/day) or carbapenem [meropenem (3 Â 1 g IV/day) or imipenem (4 Â 500 mg IV/day)] with or without amikacin (1 g IV/day). Doses were adjusted according to renal function. Clinical response was determined during and at completion of therapy. Results: One hundred and twenty episodes were assessable for efficacy (59 piperacillintazobactam, 61 carbapenem). Mean duration of treatment was 14.8 + 9.6 days in the piperacillin -tazobactam group and 14.7 + 8.8 days in the carbapenem group (P . 0.05). Mean days of fever resolution were 5.97 and 4.48 days for piperacillin -tazobactam and carbapenem groups, respectively (P . 0.05). Similar rates of success without modification were found in the piperacillin -tazobactam (87.9%) and in the carbapenem groups (75.4%; P . 0.05). Fungal infection occurrence rates were 30.5 and 18% in piperacillin -tazobactam and carbapenem groups, respectively (P ¼ 0.05). Antibiotic modification rates were 30.5 and 13.1% (P ¼ 0.02) and the addition of glycopeptides to empirical antibiotic regimens rates were 15.3 and 44.3% for piperacillin -tazobactam and carbapenem groups, respectively (P ¼ 0.001). The rude mortality rates were 14% (6/43) and 29.3% (12/41) in piperacillintazobactam and carbapenem groups, respectively (P ¼ 0.08). Conclusions: The effect of empirical regimen of piperacillin -tazobactam regimen is equivalent to carbapenem in adult febrile neutropenic patients.
Japanese Journal of Clinical Oncology, 2010
Objective: Empirical beta-lactam monotherapy has become the standard therapy in febrile neutropen... more Objective: Empirical beta-lactam monotherapy has become the standard therapy in febrile neutropenia. The aim of this study was to compare the efficacy and safety of piperacillintazobactam versus carbapenem therapy with or without amikacin in adult patients with febrile neutropenia. Methods: In this prospective, open, single-center study, 127 episodes were randomized to receive either piperacillin -tazobactam (4 Â 4.5 g IV/day) or carbapenem [meropenem (3 Â 1 g IV/day) or imipenem (4 Â 500 mg IV/day)] with or without amikacin (1 g IV/day). Doses were adjusted according to renal function. Clinical response was determined during and at completion of therapy. Results: One hundred and twenty episodes were assessable for efficacy (59 piperacillintazobactam, 61 carbapenem). Mean duration of treatment was 14.8 + 9.6 days in the piperacillin -tazobactam group and 14.7 + 8.8 days in the carbapenem group (P . 0.05). Mean days of fever resolution were 5.97 and 4.48 days for piperacillin -tazobactam and carbapenem groups, respectively (P . 0.05). Similar rates of success without modification were found in the piperacillin -tazobactam (87.9%) and in the carbapenem groups (75.4%; P . 0.05). Fungal infection occurrence rates were 30.5 and 18% in piperacillin -tazobactam and carbapenem groups, respectively (P ¼ 0.05). Antibiotic modification rates were 30.5 and 13.1% (P ¼ 0.02) and the addition of glycopeptides to empirical antibiotic regimens rates were 15.3 and 44.3% for piperacillin -tazobactam and carbapenem groups, respectively (P ¼ 0.001). The rude mortality rates were 14% (6/43) and 29.3% (12/41) in piperacillintazobactam and carbapenem groups, respectively (P ¼ 0.08). Conclusions: The effect of empirical regimen of piperacillin -tazobactam regimen is equivalent to carbapenem in adult febrile neutropenic patients.