Research Article Open Access

Cefepime Monotherapy is as Effective as Ceftriaxone Plus Amikacin in Pediatric Patients with Cancer and High-Risk Febrile Neutropenia: A Randomized Comparison

Carlos Alberto Pires Pereira1, Antonio Sérgio Petrilli1, Fabianne Altruda Carlesse1, Flávio Augusto Vercillo Luisi1, Kátia Verônica Torres Barros da Silva1 and Maria Lúcia De Martino Lee1
  • 1 GRAACC/Universidade Federal de São Paulo, Brazil

Abstract

The empirical use of antibiotic therapies is widely accepted in patients with fever and neutropenia during cancer chemotherapy. The use of intravenous monotherapy with broad-spectrum antibiotics in patients with high-risk of complications is an appropriate alternative. However, few data are available in pediatric patients. We conducted a prospective, randomized, open study in patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy. Patients were randomized to receive cefepime (CFP) or ceftriaxone plus amikacin (CFT+AK). A total of 57 patients with 125 episodes of fever and neutropenia were evaluated (CFP, 62 and CFT + AK, 63 episodes). The mean neutrophil count at admission was 118.6 cells mm-3 (CFP) and 107 cells mm-3 (CFT+AK). The mean duration of neutropenia was 9.0 days (CFP) and 8.0 days (CFT+AK). Analyzing only the first episodes of each patient, CFP treatment was successful in 65.5% of the episodes and CFT+AK were successful in 64.3%. Overall rates of success with modification were 90% (CFP) and 89% (CFT+AK). No major treatment-emergent toxicity was reported. Monotherapy with CFP seems to be as effective and safe as the combination of CFT+AK for initial empirical therapy in children and adolescents with NF.

American Journal of Infectious Diseases
Volume 4 No. 4, 2008, 237-243

DOI: https://doi.org/10.3844/ajidsp.2008.237.243

Submitted On: 12 August 2007 Published On: 31 December 2008

How to Cite: Pereira, C. A. P., Petrilli, A. S., Carlesse, F. A., Luisi, F. A. V., Barros da Silva, K. V. T. & De Martino Lee, M. L. (2008). Cefepime Monotherapy is as Effective as Ceftriaxone Plus Amikacin in Pediatric Patients with Cancer and High-Risk Febrile Neutropenia: A Randomized Comparison. American Journal of Infectious Diseases, 4(4), 237-243. https://doi.org/10.3844/ajidsp.2008.237.243

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Keywords

  • Febrile neutropenia
  • cefepime
  • high-risk
  • leukemia
  • lymphoma