Ceftolozane/Tazobactam vs. Piperacillin/Tazobactam for the Treatment of Bacteremia in Hemato-oncological Patients

Launched by INSTITUTO NACIONAL DE CANCEROLOGIA DE MEXICO · May 20, 2024

Keywords

ClinConnect Summary

This clinical trial is studying two different antibiotics, ceftolozane/tazobactam (C/T) and piperacillin/tazobactam (P/T), to see which one works better for treating blood infections (bacteremia) in patients with blood cancers and low white blood cell counts (severe neutropenia). These patients often have weakened immune systems due to chemotherapy, making them more vulnerable to infections. The trial aims to find out if C/T can provide a safer and more effective option, especially against certain tough bacteria that don't respond well to many treatments.

To join the study, participants need to be over 18 years old, have a diagnosis of a blood cancer, and show signs of fever and low white blood cell counts. They should also be stable enough to participate and expect to live for at least five more days. If selected, participants will receive one of the two antibiotics and will be monitored closely for their response to treatment. This research is important as it could help improve the care of patients facing serious infections during their cancer treatment.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • All patients \>18 years old
• • Diagnosis of any hematological malignancy
• • Severe neutropenia (polymorphonuclear \<500 cells/mm3)
• • Fever (≥38.3 degrees Celsius in one measure, or ≥38 degrees Celsius in at least two measures)
• • Median arterial pressure ≥65 mmHg on admission
• • A life expectancy ≥ 5 days
• • Agree to participate in the study
• Exclusion Criteria:
• • Known hypersensitivity to cephalosporins or anaphylaxis with beta-lactams
• • Clinical signs related to hemodynamic instability
• • Concomitant use of another antibiotic with activity against Gram-negatives (except Trimethoprim/Sulfamethoxazole (TMP/SMX) as prophylaxis for P. jirovecii
• • Patients with end-stage chronic renal failure (\<10 ml/min by creatinine clearance-ACCr) or on renal replacement therapy.
• • Patients with grade IV mucositis