Empiric Monotherapy for Febrile Neutropenia - a Randomized Study Comparing Meropenem with Ceftazidime

In this Swedish multicentre study we compared the efficacy of meropenem with ceftazidime for treatment of febrile neutropenia. 192 patients were randomized and the number of evaluable patients was 92 in the meropenem group and 95 in the ceftazidime group. 40 (43%) patients in the meropenem arm and 4...

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Bibliographic Details
Published in:Scandinavian journal of infectious diseases 1998, Vol.30 (3), p.237-243
Main Author: Ragnar Lindblad, Stig Rödjer, Magnus Adriansson, Björn Andreasson, Bengt Bäckström, Peter Johansson, Karin Karlsson, Christina Rhedin, Ingemar Turesson
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Ceftazidime - therapeutic use
Cephalosporins - therapeutic use
Female
Fever - complications
Fever - drug therapy
Humans
Male
Medical sciences
Meropenem
Middle Aged
Neutropenia - complications
Neutropenia - drug therapy
Opportunistic Infections - drug therapy
Pharmacology. Drug treatments
Thienamycins - therapeutic use
Treatment Outcome
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Summary:In this Swedish multicentre study we compared the efficacy of meropenem with ceftazidime for treatment of febrile neutropenia. 192 patients were randomized and the number of evaluable patients was 92 in the meropenem group and 95 in the ceftazidime group. 40 (43%) patients in the meropenem arm and 49 (52%) in the ceftazidime arm had acute leukaemia. 56 (61%) and 52 (55%) patients respectively had a neutrophil count of < 0.1 x 10(9)/l at randomization and the median duration of neutropenia was 6.5 and 8 d, respectively. Thirty-one (34%) and 28 (29%) patients had a microbiologically defined infection, 14 (15%) and 17 (18%) a clinically defined infection and the remaining 47 (51%) and 50 (53%) had unexplained fever. After 72 h of treatment, 46 (50%) patients in the meropenem arm and 53 (56%) patients in the ceftazidime arm were alive on unmodified monotherapy. 42 (46%) and 47 (49%) of these completed the study on monotherapy alone. Only 2 patients (2%) in each arm had to stop treatment owing to allergic reactions. None of the observed differences were statistically significant and we therefore conclude that meropenem was an effective and safe alternative to ceftazidime for empiric treatment of fever during neutropenia.
ISSN:0036-5548
1651-1980
DOI:10.1080/00365549850160864