1. ¹Department of Haematology and Medical Oncology, University Clinic Hospital, School of Medicine, University of Valencia, Valencia, Spain
2. ²Department of Statistics, University of Valencia, Valencia, Spain
3. ³Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
4. ⁴School of Nursing, University of Valencia, Valencia, Spain

Correspondence: Dr C Solano, Haematology and Medical Oncology Department, University Clinic Hospital, Blasco Ibañez 17, 46010 Valencia, Spain. E-mail: Carlos.Solano@uv.es

Received 18 August 2004; Accepted 28 February 2005; Published online 23 May 2005.

Abstract

The safety and efficacy of early bacterial prophylaxis with piperacillin–tazobactam were prospectively evaluated in 51 autologous peripheral blood stem cell transplantation (PBSCT) recipients. The results were compared with those obtained in 51 control patients receiving oral fluoroquinolones in a retrospective matched-pair control study. Overall, 76% of the study group and 98% of the control group developed at least one febrile episode during neutropenia (P=0.002). Time from neutropenia to the first febrile episode (FFE) was significantly longer in the study group than in the control group (P=0.04). Once a febrile episode appeared, the duration of fever was significantly longer in cases than in controls (median of 5 and 2 days respectively, P<0.001), and led to a more frequent use of empirical amphotericin B (AmB), not statistically significant (P=0.13). However, the total time of antibiotic administration was significantly greater in the control than in the study group (P=0.05). The duration of AmB treatment shows a trend toward a longer duration in the control than in study group (P=0.2). Overall, 86% of the Gram-positive bacteremia and 85% of the Gram-negative bacteria were susceptible to the tested antibiotics. Our study suggests that a subgroup of patients could benefit from prophylaxis with piperacillin–tazobactam without increasing toxicity or bacterial resistance.