title: Ceftazidime versus ceftazidime plus tobramycin in febrile neutropenic children.
abstract: Although the effectiveness of antibiotic monotherapy in febrile neutropenic patients remains unproven, ceftazidime has been shown previously to be effective monotherapy for the empiric treatment of selective patients. The efficacy and safety of ceftazidime versus ceftazidime plus tobramycin was evaluated in the treatment of febrile children (range 8 months to 18 years) with neutropenia secondary to cancer chemotherapeutic agents. Of the evaluable 89 patients, 45 received ceftazidime and 44 received ceftazidime plus tobramycin for 5 to 10 days. At the end of therapy, 30 (67%) of the 45 ceftazidime-treated patients were clinically cured compared with 38 (86%) of 44 combination-treated patients. Thirteen (29%) of the patients treated with ceftazidime failed to respond clinically to treatment, versus four (9%) of the patients treated with ceftazidime/tobramycin (p = 0.046). This study suggests that ceftazidime as monotherapy in febrile neutropenic children may be inferior to combination therapy for optimal clinical response in these patients.
authors.affiliation: Arkansas Children's Hospital, Little Rock.
authors.forename: R F
authors.initials: RF
authors.lastname: Jacobs
authors.forename: T S
authors.initials: TS
authors.lastname: Vats
authors.forename: K A
authors.initials: KA
authors.lastname: Pappa
authors.forename: S
authors.initials: S
authors.lastname: Chaudhary
authors.forename: M
authors.initials: M
authors.lastname: Kletzel
authors.forename: D L
authors.initials: DL
authors.lastname: Becton
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D002442:Ceftazidime / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy*; D015163:Superinfection / Q000453:epidemiology*; D014031:Tobramycin / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002442:Ceftazidime; D014031:Tobramycin