The effect of cefoperazone/sulbactam and meropenem ampırıc therapy ın neutropenıc fever of cancer and the cost analyses

Our aim is to compare the cefaperazone/sulbactam and meropenem effect with the cost analyses in neutropenic fever in Gaziantep University, Department of Pediatric Oncology and to constitute a therapy protocol for following years.We examined 97 neutropenic fever attack of 51 patients, between 1 June 2007-28 February 2008, prospectively. All attacks were evaluated for; primer tumor type, localisation and the data of the infections, the microorganisms, therapy modifications, toxicity and the cost of the therapies, and finally determined the therapy success.There were no differences between the demographic and laboratuary datas of the attacks in ampiric therapy groups, 63% of them were in lenfoproliferative and 37% of the attacks were in solid tumor groups. We could not find the localisation of the infection in 35% of the attacks but 34% of them were determined for microbiological and 31% are for clinical data. Oral cavity and the gastrointestinal tract were the most responsible for infections, 72.5% Gram (+), 35% Gram (-) and 10% of fungal. We used cefoperazone/sulbactam in 49 attacks (50.5%), and meropenem in 48 (49.5%). The success of the therapy without modification was 73.4% and 89.5% respectively, while the general success was 98% and 98%. In each group a patient died because of neutropenic septicemia. There were no differences between the groups when compared about the cost and response to the therapy. The duration of hospitalization and the controlling time of the fever is less in groups treated with meropenem, but no difference for total cost. Using the GCSF is non-effective and is not cost-effective, except in serious neutropenic attacks.Cefoperazone/sulbactam is effective as meropenem in the treatment of neutropenic fever and can be used safely.