title: Cefepime versus ceftazidime as empiric therapy for fever in neutropenic patients with cancer.
abstract: OBJECTIVE
  To compare the efficacies of cefepime and ceftazidime as empiric therapy during the management of fever in cancer patients with chemotherapy-induced neutropenia.
  
  
  METHODS
  A prospective, double-blind, randomized study of cefepime 2 g every eight hours and ceftazidime 2 g every eight hours was performed in 276 adult neutropenic (absolute neutrophil count < 500/mm3) cancer patients with fever.
  
  
  RESULTS
  Median duration of neutropenia was five days. Sixty-one percent (n = 188) of the patients were evaluable. Treatment was successful in 57% (58/101) of cefepime-treated patients and 60% (52/87) of ceftazidime-treated patients (95% CI -18 to 12; p = 0.77). Bacteremic clearance occurred in 71% (12/17) of cefepime-treated patients and 40% (6/15) of ceftazidime-treated patients (p = 0.3). Both drugs were well tolerated.
  
  
  CONCLUSIONS
  Cefepime appears to be as effective as ceftazidime in the initial treatment of febrile episodes in adult cancer patients with chemotherapy-associated neutropenia of modest duration.
authors.affiliation: Department of Internal Medicine, School of Medicine, Wayne State University, Detroit, MI, USA. pchandrasekar@intmed.wayne.edu
authors.forename: P H
authors.initials: PH
authors.lastname: Chandrasekar
authors.forename: P M
authors.initials: PM
authors.lastname: Arnow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000209:etiology; D000077723:Cefepime; D002442:Ceftazidime / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology; D009369:Neoplasms / Q000150:complications* / Q000382:microbiology / Q000401:mortality; D009503:Neutropenia / Q000209:etiology / Q000382:microbiology / Q000401:mortality; D011446:Prospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D002511:Cephalosporins; D000077723:Cefepime; D002442:Ceftazidime