Oguz Aynur, Karadeniz Ceyda, Citak Elvan Caglar, Cil Visal, Eldes Nilufer
Gazi University, Faculty of Medicine, Department of Pediatric Oncology, Ankara, Turkey.
Pediatr Hematol Oncol. 2006 Apr-May;23(3):245-53. doi: 10.1080/08880010500506867.
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.
一项针对儿科癌症患者的前瞻性、开放标签、随机对照研究，旨在评估头孢吡肟和美罗培南在发热性中性粒细胞减少症患者经验性治疗中的疗效和安全性。发热发作被分类为微生物学确诊感染、临床确诊感染或不明原因发热。治疗的临床反应被分类为成功或失败。在此期间，37名患有实体瘤（包括淋巴瘤）的儿童，25名男性，12名女性，出现了65次中性粒细胞减少。微生物学确诊感染发生在21次发作中（32.31%）。分离出的阳性细菌频率高于革兰氏阴性细菌。没有与感染相关的死亡。头孢吡肟组和美罗培南组在发热或中性粒细胞减少持续时间、反应率和调整必要性方面没有统计学差异。对于中性粒细胞减少的儿科癌症患者发热发作的经验性治疗，头孢吡肟似乎与美罗培南一样有效和安全。
