title: Experience with cefepime versus meropenem as empiric monotherapy for neutropenia and fever in pediatric patients with solid tumors.
abstract: A prospective, open-label, randomized, comparative study in pediatric cancer patients was conducted to evaluate the efficacy and safety of cefepime and meropenem in the empiric therapy of febrile neutropenic patients. Febrile episodes were classified as microbiologically documented infection, clinical documented infection, or fever of unknown origin. Clinical response to therapy was classified as success or failure. In this period 37 children with solid tumors including lymphoma, 25 males, 12 females, had neutropenia on 65 occasions. Microbiologically documented infections occurred in 21 episodes (32.31%). Frequency of positive bacteria isolated was higher than gram-negative bacteria. There was no infection-related death. There were no statistical differences between the cefepime and meropenem groups for duration of fever or neutropenia, response rate, and necessity for modification. Cefepime appears to be as effective and safe as meropenem for empiric treatment of febrile episodes in neutropenic pediatric cancer patients.
authors.affiliation: Gazi University, Faculty of Medicine, Department of Pediatric Oncology, Ankara, Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Oguz
authors.forename: Ceyda
authors.initials: C
authors.lastname: Karadeniz
authors.forename: Elvan Caglar
authors.initials: EC
authors.lastname: Citak
authors.forename: Visal
authors.initials: V
authors.lastname: Cil
authors.forename: Nilufer
authors.initials: N
authors.lastname: Eldes
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy*; D000077723:Cefepime; D002511:Cephalosporins / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000209:etiology*; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000188:drug therapy; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008297:Male; D000077731:Meropenem; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications*; D011446:Prospective Studies; D013845:Thienamycins / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D013845:Thienamycins; D000077723:Cefepime; D000077731:Meropenem