Infections are the most common cause of death in
tumor patients. The risk of
infection is progressively increased in relation to the severity of
neutropenia. It is therefore essential to start empirical
antibiotic therapy in these patients at the first sign of
infection. Forty-three neutropenic
tumor patients were entered into the above study when it was assumed that they had
bacterial infections (temperature above 38.5 degrees C and/or signs and symptoms of
infection). Patients with greater than 1000 neutrophils/mm3 were given
piperacillin alone while those with more severe
neutropenia (less than 1000/mm3) were given a combination of
piperacillin plus
amikacin. Of the 43 patients who had entered the study, 41 could be evaluated whereas the remaining two were considered dropouts either because of non-compliance with the study protocol or because the
infection was found to be non-bacterial. In both groups of patients (greater than 1000 and less than 1000 neutrophils/mm3)
infection resolved completely in a large percentage of cases (92% and 82%, respectively). The efficacy of
piperacillin was therefore reconfirmed for the management of
infection in oncologic patients with
neutropenia, and proved to be an effective therapeutic resource in patients with both slight and severe
neutropenia.