title: The efficacy and safety of cefepime or meropenem in the treatment of febrile neutropenia in patients with lung cancer. A randomized phase II study.
abstract: Febrile neutropenia frequently develops after chemotherapy. There is little evidence to indicate the type of antimicrobial agents that should be used in the treatment of febrile neutropenia in patients with solid tumors. The objective is to determine the efficacy and safety of cefepime (CFPM) and meropenem (MEPM) in the treatment of febrile neutropenia in lung cancer patients in a prospective randomized study. FN patients with lung cancer were randomly divided into CFPM or MEPM groups. The primary end-point was the response rate. The secondary end-points were the defervescence rates at 72 h, 7 days, 14 days and the incidence of adverse events. Twenty-one patients were treated with CFPM and 24 patients were treated with MEPM. One patient died of FN. The CFPM treatment completion rate was 17.65% (95% CI; 0.00-35.77%), while the MEPM treatment completion rate was 38.10% (95% CI; 17.33-58.87%). The defervescence rates at 72 h, 7 days, and 14 days were 70.59%, 86.67%, and 100.00%, respectively in the CFPM group; and 65.00%, 84.21%, and 92.31% in the MEPM group. Adverse events were observed in 33.33% of the CFPM group and 45.83% of the MEPM group. The response rate of the CFPM group was 94.12% (95% CI; 73.02-98.95%), while that of the MEPM group was 85.71% (95% CI; 65.36-95.02%). No differences were found in the efficacy or safety of CFPM and MEPM in the treatment of febrile neutropenia in patients with lung cancer.
authors: Department of Respiratory Medicine, Fukuoka University Hospital, Japan. Electronic address: mfujita@fukuoka-u.ac.jp.
authors: Masaki
authors: M
authors: Fujita
authors: Department of Respiratory Medicine, Fukuoka University Hospital, Japan.
authors: Takemasa
authors: T
authors: Matsumoto
authors: Department of Respiratory Medicine, Japan Community Health Care Organization Isahaya General Hospital, Japan.
authors: Yuuichi
authors: Y
authors: Inoue
authors: Department of Internal Medicine, Saiseikai Fukuoka General Hospital, Japan.
authors: Hiroshi
authors: H
authors: Wataya
authors: Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Japan.
authors: Koichi
authors: K
authors: Takayama
authors: Department of Infections Disease, Nagasaki University Hospital, Japan.
authors: Masayuki
authors: M
authors: Ishida
authors: Department of Respiratory Oncology, Iizuka Hospital, Japan.
authors: Noriyuki
authors: N
authors: Ebi
authors: Department of Research and Development of Next Generation Medicine, Faculty of Medical Sciences, Kyushu University, Japan.
authors: Junji
authors: J
authors: Kishimoto
authors: Clinical Research Institute, National Kyushu Cancer Center, Japan.
authors: Yukito
authors: Y
authors: Ichinose
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D000077723:Cefepime; D002511:Cephalosporins / Q000009:adverse effects / Q000627:therapeutic use*; D064147:Febrile Neutropenia / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications*; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D011446:Prospective Studies; D013845:Thienamycins / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D002511:Cephalosporins; D013845:Thienamycins; D000077723:Cefepime; D000077731:Meropenem
keywords: Cefepime; Febrile neutropenia; Lung cancer; Meropenem