Cefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison

Cefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison

Autor Pires Pereira, Carlos Alberto Autor UNIFESP Google Scholar
Petrilli, Antonio Sergio Autor UNIFESP Google Scholar
Carlesse, Fabianne Altruda Google Scholar
Vercillo Luisi, Flavio Augusto Google Scholar
Torres Barros da Silva, Katia Veronica Google Scholar
Martino Lee, Maria Lucia de Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Background and purpose: The empirical use of antibiotic therapy is widely accepted for patients with fever and neutropenia during cancer chemotherapy. The use of intravenous monotherapy with broad-spectrum antibiotics in patients at high risk for complications is an appropriate alternative. However, few data are available for pediatric patients. The aim of this study was to compare the efficacy and safety of cefepime (CFP) monotherapy with ceftriaxone plus amikacin (CFT+AK) in children and adolescents with febrile neutropenia (FN).Methods: A prospective randomized open study of patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy was conducted. Patients were randomized to receive UP or CFT+AK. The randomization was based on number lists.Results: Fifty seven patients with 125 episodes of fever and neutropenia were evaluated (CFP, 62 episodes; CFT+AK, 63 episodes). The mean neutrophil count at admission to hospital was 118.6 cells/mm(3) for patients in the CFP group and 107 cells/mm(3) for patients in the CFT+AK group. The mean duration of neutropenia was 9 days for the UP group and 8 days for the CFT+AK group. Analysis of only the first episodes for each patient showed that UP treatment was successful for 65.5% of episodes and CFT+AK was successful for 64.3% of episodes. The overall rates of success with modification were 90% for the UP group and 89% for the CFT+AK group. No major treatment-emergent toxicity was reported.Conclusion: Monotherapy with UP seems to be as effective and safe as CFT+AK for initial empirical therapy in children and adolescents with FN.
Assunto Cefepime
Leukemia
Lymphoma
Neutropenia
Risk
Idioma Inglês
Data 2009-04-01
Publicado em Journal Of Microbiology Immunology And Infection. Taipei: Scientific Communications Int Ltd, v. 42, n. 2, p. 141-147, 2009.
ISSN 1684-1182 (Sherpa/Romeo, fator de impacto)
Editor Scientific Communications Int Ltd
Extensão 141-147
Fonte http://www.ejmii.com/issue_abstract.php?code=PDT4b0cce7d090c6
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000271205800007
URI http://repositorio.unifesp.br/11600/44508

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