A randomised comparison of ceftazidime and piperacillin, both in combination with flucloxacillin for treatment of febrile episodes in neutropenic children. Finnish Three-Centre Study.
111 febrile episodes in 98 neutropenic children were randomly treated with either ceftazidime (CAZ) 150 mg/kg/day or with piperacillin (PIP) 200 mg/kg/day, both combined with flucloxacillin (FLUC) 50 mg/kg/day. A total of 37/47 (79%) eligible episodes in the CAZ group and 41/53 (77%) in the PIP group were cured without needing to stop the initial therapy. The success without modification of the treatment in the verified septicaemias in the CAZ group was 8/18 (44%) and in the PIP group 5/18 (28%). Of the bacteriologically documented infections, 13/24 (54%) in the CAZ group and 11/24 (46%) in the PIP group were cured without modification of the therapy. Similarly, 17/31 (55%) of all the isolated bacteria in the CAZ group and 14/33 (42%) in the PIP group were eradicated with the initial therapy. Overall there were 13 deaths of which 4 in the CAZ group and 5 in the PIP group occurred during the infection. An increasing granulocyte count exceeding 0.25 x 10(9)/l at the end of the therapy was a good prognostic sign for the outcome of the infection. This study indicates that CAZ is as effective as PIP in the treatment of infections in neutropenic children.
Perkkiö
M
M
Department of Paediatrics, University Hospital of Helsinki, Finland.
Hovi
L
L
Rajantie
J
J
Lanning
M
M
Salmi
T
T
Williams
K
K
Mäkipernaa
A
A
Ruuskanen
O
O
Renkonen
O V
OV
Herva
E
E
D000293:Adolescent; D000380:Agranulocytosis / Q000188:drug therapy*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000401:mortality; D002442:Ceftazidime / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003023:Cloxacillin / Q000031:analogs & derivatives*; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000188:drug therapy*; D005387:Finland; D005436:Floxacillin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D009503:Neutropenia / Q000188:drug therapy* / Q000401:mortality; D010878:Piperacillin / Q000008:administration & dosage / Q000627:therapeutic use*; D011897:Random Allocation; D013997:Time Factors
D005436:Floxacillin; D002442:Ceftazidime; D003023:Cloxacillin; D010878:Piperacillin