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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2020; 41(04): 570-576
DOI: 10.4103/ijmpo.ijmpo_237_20
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Commentary on Cefepime versus Cefoperazone/Sulbactam in Combination with Amikacin as Empirical Antibiotic Therapy in Febrile Neutropenia

Smita Kayal
Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Ponraj Madasamy
Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Jogamaya Pattnaik
Department of Medical Oncology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Introduction

Febrile neutropenia (FN) remains an oncologic emergency since the advent of chemotherapy. Its significance was recognized in 1970s which led to empirical antibiotic use and resulted in major reduction of mortality from 50% to 26% due to neutropenic fever and sepsis.[1] Since then, several international guidelines have defined use of first line and subsequent lines of antibiotics in settings of high risk FN.[2],[3],[4],[5] For choice of first-line empirical antibiotic therapy (EAT), there is not one standard across all guidelines or institutes, many options exist directed by randomized controlled trails (RCTs) in different settings and guided by local antibiotic sensitivity data. We conducted a RCT comparing cefepime monotherapy versus cefoperazone/sulbactam with amikacin as EAT in FN at our center representative of a low resource setting with high prevalence of antibiotic resistance.[6] Its been almost 2 years since the publication of results in May 2018, and we hereby review further developments in the same area and the current relevance of our study results.



Publication History

Received: 17 May 2020

Accepted: 03 July 2020

Article published online:
17 May 2021

© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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