Meropenem compared with ceftazidime in the empiric treatment of acute severe infections in hospitalized children. Italian Pediatric Meropenem Study Group.
In a multicenter, randomized, open comparison of meropenem to ceftazidime as empiric treatment of severe acute infections, 185 children (1 mo-15 years old, mean 65.4 mo) were enrolled. Meropenem (20 mg/kg t.i.d. i.v.) was given to 98 and ceftazidime (10-30 mg/kg t.i.d. i.v.) to 87 children, generally for 5 to 10 days (mean: 6.9 for meropenem and 7.5 for ceftazidime). Clinical response was evaluated at the beginning and at the end of therapy and 4 weeks later (follow-up). Clinical response was deemed satisfactory at the end of therapy in 96.7% of the patients treated with meropenem and in 95.3% of those who received ceftazidime without any statistically significant difference. One relapse occurred in a meropenem-treated patient at the follow-up clinical assessment. The baseline infecting organism was eradicated or presumed eradicated at the end of therapy in 14/16 patients treated with meropenem and in 14/15 treated with ceftazidime. The incidence of drug-related adverse events (mostly a slight increase in liver enzymes) was 9.2% in the meropenem group and 4.6% in the ceftazidime group. Our data show that meropenem is as effective as ceftazidime in the empiric treatment of severe infections in infants and children.
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Department of Pediatrics (IV), Milan University Medical School, Italy.
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D000293:Adolescent; D001424:Bacterial Infections / Q000188:drug therapy*; D002442:Ceftazidime / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016903:Drug Monitoring; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000187:drug effects / Q000201:enzymology; D000077731:Meropenem; D012141:Respiratory Tract Infections / Q000188:drug therapy; D018805:Sepsis / Q000188:drug therapy; D012874:Skin Diseases, Infectious / Q000188:drug therapy; D013845:Thienamycins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy
D002511:Cephalosporins; D013845:Thienamycins; D002442:Ceftazidime; D000077731:Meropenem