International Journal of Hematology and Oncology 2023, Vol 33, Num 4 Page(s): 034-039
The Clinical Efficacy of Cephoperazone-Sulbactam and Amikacin Sulfate Combination in Pediatric Febrile Neutropenic Patients

Pamir ISIK1, Nese YARALI 1, Ali BAY2, Rukiye SAC1, Abdurrahman KARA1, Bahattin TUNC1

1Dr. Sami Ulus Children’s Hospital, Department of Pediatric Hematology, Ankara
2Gaziantep University, Department of Pediatric Hematology, Gaziantep, TURKEY

Keywords: Febrile neutropenia, Cephoperazone-sulbactam
The efficacy of cephoperazone-sulbactam and amikacin sulfate combination in febrile neutropenic patients followed in pediatric hematology department was retrospectively evaluated in this study.
We retrospectively investigated 20 patients whom were treated with the cephoperazone-sulbactam and amikacin sulfate combination due to febrile neutropenia between June 2007 and February 2008 which were followed in pediatric hematology department of our hospital. Their diagnoses were acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), Fanconi aplastic anemia (FAA) and acquired aplastic anemia (AA). All cultures of patients were taken and then 3 doses of 150 mg/kg/day cephoperazone-sulbactam intravenously and one dose of 15 mg/kg/day amikacine sulphate intravenously were administered. Patients were divided into 3 groups according to the clinical findings and C-reactive protein (CRP) levels in the 5th day of treatment.
The response to cephoperazone-sulbactam-amikacin treatment was good in 14 patients, moderate in 2 patients and poor in 4 patients. The average time for fever to decrease were 2.5 days in good response group and 5 days in moderate
response group, while average time for fever to decrease was more than 5 days in poor response group. Statistically the 5th day absolute neutrophile value was not significantly higher between the groups. The efficacy ratio of the drug was %70.
Although cephoperazone-sulbactam plus amikacin regimen was shown to be effective in febrile neutropenia treatment of pediatric hematology patients, large prospective clinical trials are necessary to determine the clinical affectivity and safety of that particular regimen in patients with ANC values of 500 /μl and lower.