Cefoperazone for the Treatment of Infections in Patients with Cancer

Cefoperazone was used for the treatment of 105 febrile episodes in 103 patients with cancer. A dose of 12 g/day was administered according to two different schedules, one for neutropenic patients (neutrophil count, less than 1,000/mm3), the other for nonneutropenic patients. The rate of response for 85 episodes of documented infection was 68%. The rates of response for patients with bacteremia and pneumonia were 72% and 41%, respectively; all patients with soft-tissue and urinary-tract infections responded. Fifty-five percent of patients infected with Pseudomonas aeruginosa, the most common gram-negative organism causing infection, responded to therapy. Among patients infected with Staphylococcus aureus, the most common gram-positive organism causing infection, 82% responded. As expected, the rate of response was higher for patients with adequate neutrophil counts. In neutropenic patients the overall response was good, particularly when the neutropenia resolved. However, the occasional occurrence of resistant strains of bacteria precludes the use of cefoperazone alone as initial therapy for neutropenic patients. Toxic adverse reactions, including drug-induced fever, diarrhea, and rash, occurred rarely and were transient. This study indicates that cefoperazone has low toxicity and is effective for the treatment of infections in patients with cancer.