EXPERIENCE WITH CEFEPIME VERSUS MEROPENEM AS EMPIRIC MONOTHERAPY FOR NEUTROPENIA AND FEVER IN PEDIATRIC PATIENTS WITH SOLID TUMORS

A prospective, open-label, randomized, comparative study in pediatric cancer patients was conducted to evaluate the efficacy and safety of cefepime and meropenem in the empiric therapy of febrile neutropenic patients. Febrile episodes were classified as microbiologically documented infection, clinic...

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Bibliographic Details
Published in:Pediatric hematology and oncology 2006-04, Vol.23 (3), p.245-253
Main Authors: Oguz, Aynur, Karadeniz, Ceyda, Citak, Elvan Caglar, Cil, Visal, Eldes, Nilufer
Format: Article
Language:English
Subjects:
Adolescent
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - complications
Bacterial Infections - drug therapy
cefepime
Cephalosporins - therapeutic use
Child
Child, Preschool
febrile neutropenia
Female
Fever - etiology
Gram-Negative Bacterial Infections - complications
Gram-Negative Bacterial Infections - drug therapy
Gram-Positive Bacterial Infections - complications
Gram-Positive Bacterial Infections - drug therapy
Humans
Infant
Male
meropenem
Neoplasms - complications
Neoplasms - drug therapy
Neutropenia - chemically induced
Neutropenia - complications
Prospective Studies
solid tumor
Thienamycins - therapeutic use
Treatment Outcome
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Summary:A prospective, open-label, randomized, comparative study in pediatric cancer patients was conducted to evaluate the efficacy and safety of cefepime and meropenem in the empiric therapy of febrile neutropenic patients. Febrile episodes were classified as microbiologically documented infection, clinical documented infection, or fever of unknown origin. Clinical response to therapy was classified as success or failure. In this period 37 children with solid tumors including lymphoma, 25 males, 12 females, had neutropenia on 65 occasions. Microbiologically documented infections occurred in 21 episodes (32.31%). Frequency of positive bacteria isolated was higher than gram-negative bacteria. There was no infection-related death. There were no statistical differences between the cefepime and meropenem groups for duration of fever or neutropenia, response rate, and necessity for modification. Cefepime appears to be as effective and safe as meropenem for empiric treatment of febrile episodes in neutropenic pediatric cancer patients.
ISSN:0888-0018
1521-0669
DOI:10.1080/08880010500506867