Ferdosian F, Ghiliyan R, Hashemi A, Akhondzadeh B, Gholampoor E
Department of Pediatrics, Shahid Sadoughi University of Medical Science and Health Services, Yazd, Iran.
Internal Medicine. Hematology oncology and Genetics Research Center Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Iran J Ped Hematol Oncol. 2013;3(3):103-7. Epub 2013 Jul 22.
In cancer patients, various infections were developed due to severe neutropenia resulted from chemotherapy. Ceftazidime is commonly used as monotherapy of cancer patients with fever and neutropenia. Meropenem is a new carbapenem with more extended antibacterial spectrum including anaerobes. It provides better coverage against gram positives. This trial compared the efficacy and safety of meropenem with ceftazidime as empirical monotherapy for febrile neutropenia in pediatric patients with cancer.
A prospective, double-blind, randomized clinical trial was conducted at Departments of Pediatric Haematology/Oncology, University Hospitals, Yazd, Iran, during the years 2012 to 2013. A total of 48 cancer patients participated in the trial.
In this study, 26 patients (54.16%) were treated by ceftazidime and 22 patients (45.84%) by meropenem. Mean duration of fever in those who responded to treatment in ceftazidime group was 19.43+/-31.04 hours, and in meropenem group was 16.53+/-28.77 hours (P-value = 0.965).
Finding of this study indicate that ceftazidime and meropenem have similar efficacy in treatment of fever and sever neutropenia. Due to more availability and lower cost of ceftazidime than meropenem, ceftazidime is suggested as a first line treatment in fever and neutropenia.
在癌症患者中，化疗导致的严重中性粒细胞减少会引发各种感染。头孢他啶通常用作癌症发热伴中性粒细胞减少患者的单一疗法。美罗培南是一种新型碳青霉烯类药物，抗菌谱更广，包括厌氧菌，对革兰氏阳性菌的覆盖性更好。本试验比较了美罗培南与头孢他啶作为经验性单一疗法治疗儿童癌症患者发热性中性粒细胞减少的疗效和安全性。
2012年至2013年期间，在伊朗亚兹德大学医院儿科血液学/肿瘤学部门进行了一项前瞻性、双盲、随机临床试验。共有48名癌症患者参与了该试验。
在本研究中，26名患者（54.16%）接受了头孢他啶治疗，22名患者（45.84%）接受了美罗培南治疗。头孢他啶组治疗有反应患者的平均发热持续时间为19.43±31.04小时，美罗培南组为16.53±28.77小时（P值 = 0.965）。
本研究结果表明，头孢他啶和美罗培南在治疗发热和严重中性粒细胞减少方面疗效相似。由于头孢他啶比美罗培南更易获得且成本更低，建议将头孢他啶作为发热和中性粒细胞减少的一线治疗药物。
