Chemotherapy-induced neutropenia and fever in patients receiving cisplatin-based chemotherapy for ovarian malignancy

Gynecol Oncol. 1991 Jan;40(1):17-20. doi: 10.1016/0090-8258(91)90077-i.

Abstract

Fifty-six episodes of chemotherapy-induced neutropenia and fever occurred in forty-three patients receiving cisplatin-based combination chemotherapy for ovarian cancer. All patients were treated with broad-spectrum antibiotics including gentamicin. Twelve of fifty-six episodes were associated with positive cultures; in six patients a single organism was isolated, and the other six patients had polymicrobial infection. The mean duration of antibiotic therapy was 6.5 days. One patient died of sepsis. Fifty-five episodes had a successful outcome. There was no antibiotic-related morbidity. Based on this review we recommend broad-spectrum antibiotic therapy for chemotherapy-induced neutropenia with fever. The regimen of gentamicin plus ticarcillin and clavulanic acid (ceftazidime for penicillin-allergic patients) is effective as initial therapy. Additional agents (i.e., vancomycin) may be necessary in culture-positive patients based on sensitivity testing of bacterial isolates. Gentamicin can be safely administered to patients receiving cisplatin-based chemotherapy without compromising ability to continue cisplatin therapy in subsequent treatment cycles.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / drug therapy
  • Cisplatin / adverse effects*
  • Cisplatin / therapeutic use
  • Drug Therapy, Combination / therapeutic use
  • Female
  • Fever / chemically induced*
  • Gentamicins / therapeutic use
  • Humans
  • Length of Stay
  • Middle Aged
  • Neutropenia / chemically induced*
  • Ovarian Neoplasms / complications
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / epidemiology
  • Retrospective Studies
  • Ticarcillin / therapeutic use
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Gentamicins
  • Vancomycin
  • Ticarcillin
  • Cisplatin