Background: Febrile neutropenia (FN) continues to represent a major cause of morbidity, mortality, and cost in patients receiving cancer chemotherapy. The prompt initiation of empirical antibiotics in febrile neutropenia has been the most important advance in the management of the immuno–compromised host. There is limited data on efficacy of different broad spectrum antibiotics in Indian population. Present study was undertaken to compare the efficacy of two broad spectrum antibiotics in febrile neutropenia patients.

Methods: This study was conducted on patients of hematological malignancies  who presented to hematology and medicine department of PGIMS, Rohtak  and developed fever with neutropenia. Patients were divided in 2 groups– group A and group B. Group A patients were given imipenem–cilastatin and group B patients were given ceftazidime. Both groups were evaluated for cause of fever. Two groups were compared based on type of leukemia, clinical features at presentation, neutrophil count, duration of neutropenia, time of defervescence, clinical response to treatment and number of deaths.

Results:  Baseline characters were comparable in both groups. Gram negative bacterial infections were more common than gram positive. Mean time of defervescence i e disappearance of fever was 8.7±3.23 days in group A and 8.15±2.97 days in group B. The difference was not significant. (p value >.05). total of 19 patients responded to treatment. They had disappearance of all clinical signs of infection on day 7. Ten patients (66.6%) in group A and 9 patients (60%) in group B responded to treatment. The difference in response was not clinically significant. (p value > 0.05).

Conclusion: The present study demonstrated response rate of 66.6% in patients of febrile neutropenia treated with imipenem–cilastatin and 60% in patients treated with ceftazidime plus amikacin. The difference however was not statistically significant. Since this study involved only 30 patients, other studies with large number of patients are needed to unravel the efficacy of these drugs in febrile neutropenia.