Monotherapy with meropenem versus combination therapy with ceftazidime plus amikacin as empirical therapy for neutropenic fever in children with malignancy

Kuo Chen Hung, Hsiu Hui Chiu, Ya Chun Tseng, Jen Hsian Wang, Hsiao Chuan Lin, Fuu-Jen Tsai, Ching Tien Peng

    Research output: Contribution to journalArticle

    23 Scopus citations

    Abstract

    Fifty-four pediatric cancer patients with a total of 100 febrile neutropenic episodes treated at China Medical College Hospital were randomized to receive meropenem or ceftazidime plus amikacin from January 2001 to April 2002. The characteristics of 76 assessable febrile episodes (39 with meropenem and 37 with ceftazidime plus amikacin) were compared between the 2 groups. The success rate with unmodified therapy was not significantly different between the meropenem group (72%) and the ceftazidime-plus-amikacin group (57%). The incidence of side effects was similar between the 2 groups and these side effects were reversible. Microbiologically documented infection, clinically documented infection, and unexplained fever accounted for 35%, 37%, and 28% of episodes, respectively. The clinical response rates in subgroups of documented infection and unexplained fever did not significantly differ between the 2 treatment groups. Meropenem was significantly more effective than ceftazidime plus amikacin in children at high risks of developing severe infection who had profound neutropenia (absolute neutrophil count [ANC] <100/mm3), prolonged neutropenia (ANC <500/mm3 lasting for >10 days), or clinically deteriorating shock (p=0.045). As an empirical treatment, meropenem seems to be as effective and safe as ceftazidime plus amikacin for febrile episodes in children with cancer and neutropenia. Meropenem is more effective for pediatric cancer patients at the high risk of severe infection.

    Original languageEnglish (US)
    Pages (from-to)254-259
    Number of pages6
    JournalJournal of Microbiology, Immunology and Infection
    Volume36
    Issue number4
    StatePublished - Dec 2003

    Keywords

    • Ceftazidime/amikacin
    • Meropenem
    • Neutropenic fever

    ASJC Scopus subject areas

    • Microbiology (medical)
    • Immunology and Allergy
    • Immunology and Microbiology(all)

    Fingerprint Dive into the research topics of 'Monotherapy with meropenem versus combination therapy with ceftazidime plus amikacin as empirical therapy for neutropenic fever in children with malignancy'. Together they form a unique fingerprint.

  • Cite this