World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
Journal website http://www.wjon.org

Original Article

Volume 6, Number 1, February 2015, pages 283-291


A Comparative Study of Piperacillin-Tazobactam With and Without Vancomycin as Empirical Therapy for Febrile Neutropenic Patients With Solid Tumor Malignancies

Tables

Table 1. Patients Demographic, Frequency of Malignancies and Outcome of Logistic Regression Analysis of PT and PT + VM therapies
 
VariablesPTPT + VMOdds ratio (Exp(B))95% CIX2 stat (df)P value (Wald)
FemaleMaleFemaleMale
NC: not computed; PT: piperacillin-tazobactam; VM: vancomycin.
Age, median (range)49.11 (51)58.11 (58)53.45 (47)47.45 (65)0.9970.964 - 1.0300.040 (1)0.841
Sex, gender35 (58.33%)25 (41.67%)16101.1430.445 - 2.9320.077 (1)0.781
Malignancy type
  Colorectal Ca11 (55%)9 (45%)3 (60%)2 (40%)NilNil26.874 (14)0.841
  Breast Ca18 (100%)04 (100%)0
  Ca pancreas1 (20%)4 (80%)01 (100%)
  Lung Ca04 (100%)1 (50%)1 (50%)
  Sarcoma1 (33.3%)2 (66.7%)3 (75%)1 (25%)
  Gallbladder Ca1 (50%)1 (50%)00
  Malignant of bile duct01 (100%)00
  Esophagus Ca01 (100%)01 (100%)
  Ovarian Ca1 (100%)01 (100%)0
  Prostate Ca02 (100%)00
  Squamous cell Ca1 (100%)000
  Testicular Ca01 (100%)03 (100%)
  Nasopharynx001 (50%)1 (50%)
  Uterus Ca003 (100%)0
Chemotherapy9.8182.127 - 45.32113.258 (1)0.003
  < 12 days21 (63.6%)12 (36.4%)15 (62.5%)9 (37.5%)
  > 12 days14 (51.9%)13 (48.1%)1 (50%)1 (50%)
  Success0.0000.000 - 0.0000.725 (1)1.000
    < 7 days35 (59.3%)24 (40.7%)16 (59.3%)10 (38.5%)
    > 7 daysNil1 (100%)NilNil
  Mortality (within sex)NCNCNCNC
    YesNilNilNilNil
    No35 (100%)25 (100%)16 (100%)10 (100%)

 

Table 2. Response to Therapy of PT Versus PT + VM Treatment Groups
 
Effectiveness variablesBaselinePTPT + VMOdds ratio95% CIX2 stat (df)P value
Frequency (F)Frequency (M)Frequency (F)Frequency (M)
Fever< 38.1 °C35 (58.3%)25 (41.7%)16 (61.5%)10 (38.5%)NCNCNCNC
> 38.1 °CNilNilNilNil
Pleural effusionYes9 (56.2%)7 (43.8%)3 (50%)3 (50%)0.8250.281 - 2.4220.124 (1)0.726
No26 (59.1%)18 (40.9%)13 (65%)7 (35%)
ConsolidationYes5 (14.3%)4 (16%)4 (25%)3 (30%)2.0880.682 - 6.3951.621 (1)0.197
No30 (58.8%)21 (41.2%)12 (63.2%)7 (36.8%)

 

Table 3. Overall Outcome of PT Versus PT + VM Therapies
 
Outcome variablesGenderPTPT + VMX2 stat (df)P value
Duration (median)Mean rankDuration (median)Mean rank
Duration of fever (days), median (range)F2 (5)40.932 (5)49.420.012 (1)0.114
M1 (6)2 (3)
Duration of neutropenia (days), median (range)F4 (10)38.746 (5)54.487.387 (1)0.007
M7 (13)7.5 (6)
Length of stay (day), median (range)F7 (49)44.858 (55)40.380.583 (1)0.445
M13 (38)7.5 (22)
Duration of therapy (days), median (range)F6 (13)43.69PT: 6 (7)
VM: 5 (12)
43.06/13.500.012 (1)0.913
M7 (13)PT: 6 (11)
VM: 3 (10)

 

Table 4. Bacterial Spectrum, Susceptibility and Resistance Patterns of Microorganisms
 
OrganismsNumber of isolates%PTVMOC
S %R %S %R %S %R %
Gram-positive organisms
  Staphylococcus aureus735%--100071.4828.52
  Streptococcus spp735%--100069.5530.45
  Corynebacterium spp315%------
  Enterococcus spp210%--98.851.15NilNil
  Staphylococcus spp15%--99.80.213.7386.27
Gram-negative organisms
  Escherichia coli1860%79.9220.08----
  Klebsiella pneumoniae413.33%69.2330.77----
  Pseudomonas spp310%83.2316.77----
  Aeromonas hydrophylia13.33%------
  Stenotropomonas multipholia13.33%------
  Serratia marcescens13.33%93.666.34----
  Providencia stuartii13.33%------
  Enterobacter spp13.33%67.4132.59----

 

Table 5. Logistic Regression Analysis of Variables Associated With Treatment Success Without Treatment Modification
 
VariablesUnivariate OR (95% CI)Univariate (P)Multivariate OR (95% CI)Multivariate (P)
ALP: alkaline phasphatase; AST: aspartate aminotransferase; GGT: gama-glutamyl transepiptidase.
Chemotherapy, < 12 days vs. > 12 days9.818 (2.127 - 45.32)0.0033.442 (1.29 - 754.09)0.034
Lung consolidation, yes vs. no2.088 (0.682 - 6.395)0.1972.305 (1.323 - 75.003)0.026
Blood pressure, baseline: 90/60 to 130/90 mm Hg vs. < 80/50 and > 200/120 mm Hg0.078 (0.024 - 0.258)0.001-3.094 (0.005 - 0.386)0.005
WBC, baseline: 4.5 - 11 × 109/L vs. < 4.5 - 11 × 109/L0.233 (0.084 - 0.652)0.005-1.923 (0.021 - 1.01)0.051
Hemoglobin, baseline: 13.5 - 17.5 g/dL vs. < 13.5 - 17.5 g/dL0.146 (0.053 - 0.404)0.001-2.628 (0.011 - 0.477)0.006
Blood urea nitrogen, baseline: 2.7 - 7.2 mmol vs. < 2.7 - > 7.2 mmol0.267 (0.102 - 0.700)0.007-1.343 (0.049 - 1.382)0.114
Serum creatinine level, baseline: F, 47 - 115/M, 53 - 88 mmol/L vs. > 47 - 115/M, > 53 - 88 mmol3.319 (0.692 - 15.919)0.134-0.173 (0.046 - 15.466)0.907
ALP, baseline: 54 - 144 mmol/L vs. > 144 mmol/L5.111 (1.380 - 18.929)0.0152363 (0.571 - 193.476)0.113
AST, baseline: 8 - 38 U/L vs. > 38 U/L6.25 (0.768 - 50.860)0.0871.546 (0.051 - 432.207)0.503
GGT, baseline: 15 - 85 U/L vs. > 85 U/L2.539 (0.931 - 6.928)0.0690.422 (0.14 - 16.174)0.726