Comparison of double beta-lactam antibiotics (cefoperazone/mezlocillin or cefoperazone/piperacillin) with ticarcillin/tobramycin/cefazolin in febrile neutropenic patients

Seventy patients experienced 103 episodes of fever while neutropenic. Fifty-one patients received empiric therapy with a double beta-lactam combination (cefoperazone and mezlocillin or cefoperazone and piperacillin) and 52 received ticarcillin/tobramycin/cefazolin. Although only 25% in each group defervesced without additional antimicrobial therapy, 82% of the double beta-lactam patients and 90% of the aminoglycoside patients recovered from the neutropenic episode. Break-through bacteremias with Staphylococcus sp were identified more commonly in patients receiving ticarcillin/tobramycin/cefazolin. Gram-negative bacilli were identified in both groups. Equivalent efficacy, ease of administration and lower cost favor the use of cefoperazone and mezlocillin as empiric therapy for febrile neutropenic patients.