[Clinical effects and safety of piperacillin/tazobactam in treating neutropenic febrile patients with malignant hematopathy].

ABSTRACT

OBJECTIVE: To evaluate the effect and safety of piperacillin/tazobactam on neutropenic febrile patients with Malignant Hematopathy. METHODS: 218 patients with malignant hematopathy complicated by infectious fever, 162 (74.31%) with fever of unknown origin (FUO), 33 (15.14%) with clinically defined infection (CDI), and 23 (10.55%) with microbiologically defined infection (MDI), underwent intravenous drip of piperacillin/tazobactam at the dose of 4.5 g for 30 min every 8 hours till 4 - 5 d after the temperature returned to normal or neutropenia was relieved. Twenty hours before and after treatment blood routine, blood biochemical and electrolytes, and bacteriological examination, chest X-ray examination were conducted. The changes of symptoms and signs were observed. RESULTS: The total effective rate was 65.60%, the bacteria clearance rate was 71.43%, and the adverse reaction rate was 5.04%. The average defervescence time was (2.5 +/- 1.2) days, and the duration of antibiotic therapy was (9.4 +/- 8.1) days. There were not significant differences in the curative effect and defervescence time between the patients undergoing chemotherapy and those undergoing hematopoietic stem cell transplantation (chi2 = 2.058, P > 0.05, and t = 1.892, P > 0.05). After the piperacillin/tazobactam treatment the white blood cell count and absolute neutrophile granulocyte count of the patients significantly increased (t = 4.092, P < 0.01; t = 4.248, P < 0.01). However, the hepatic and renal functions did not change obviously after treatment. CONCLUSIONS: Piperacillin/tazobactam therapy is effective and safe empirical antibacterial therapy in febrile neutropenic patients with hematological malignancies.