Comparison of cefepime versus ceftriaxone-amikacin as empirical regimens for the treatment of febrile neutropenia in acute leukemia patients
| Autor: | José R. Borbolla, Manuel López-Hernández, Rosa María Romero Jiménez, Mauricio González-Avante, Elvira Trueba, Martha Alvarado, José DeDiego |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Neutropenia Adolescent Fever medicine.medical_treatment Cefepime macromolecular substances hemic and lymphatic diseases Internal medicine Drug Discovery Antineoplastic Combined Chemotherapy Protocols Medicine Humans Pharmacology (medical) Intensive care medicine Child Amikacin Antibacterial agent Aged Pharmacology Chemotherapy Acute leukemia Leukemia business.industry Ceftriaxone Infant General Medicine Bacterial Infections Middle Aged medicine.disease Anti-Bacterial Agents Cephalosporins Infectious Diseases Oncology Child Preschool Drug Therapy Combination Female business Febrile neutropenia medicine.drug |
| Zdroj: | Chemotherapy. 47(5) |
| ISSN: | 0009-3157 |
| Popis: | Background: High-intensity regimes of chemotherapy have led to longer and more severe episodes of neutropenia with a resulting increase in morbidity and mortality due to infections. Which empiric antibiotic regimen to use in these cases is still under debate. Methods: We performed a randomized comparative study to evaluate the efficacy of cefepime versus ceftriaxone plus amikacin as the initial treatment in an escalating, empirical, antibiotic therapy regimen in febrile neutropenic patients. Both adults and children were included. All patients had less than 500 neutrophils/µl at the time of infection. Patients were randomized to receive either cefepime or ceftriaxone plus amikacin. If infection continued 72 h later, patients in both groups received vancomycin, and if infection had not disappeared 7 days after starting antibiotics, amphotericin B was started. Results: Twenty patients were included in each group. Both treatment and control groups were comparable for age and sex, among other factors. There were 18 cures in the cefepime group and 17 in the ceftriaxone plus amikacin group (p = 0.9). No patient discontinued therapy because of toxicity. Conclusions: Cefepime is a safe and very effective therapy for patients with acute leukemia and febrile neutropenia; in addition, it is a cheaper regimen in our country, and lacks the potential toxicity of the aminoglycosides. |
| Databáze: | OpenAIRE |
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