PMID: 9540761Apr 16, 1998Paper

Meropenem monotherapy versus combination therapy with ceftazidime and amikacin for empirical treatment of febrile neutropenic patients

Annals of Hematology
G BehreW Hiddemann

Abstract

Infections remain the major cause of morbidity and mortality among neutropenic cancer patients. The current study addresses the question whether monotherapy with the new broad-spectrum carbapenem meropenem exhibits efficacy comparable to that of the standard combination therapy with ceftazidime and amikacin for empirical treatment of febrile neutropenic patients. Seventy-one patients with hematological malignancies (55%) or solid tumors (45%), neutropenia < 500/microliter, and fever > 38.5 degrees C were randomly assigned to either meropenem (1 g every 8 h) or ceftazidime (2 g every 8 h) and amikacin (15 mg/kg/day) intravenously. Meropenem (n = 34) and ceftazidime/amikacin (n = 37) were equivalent with respect to the clinical response at 72 h (62% versus 68%) (p > 0.05) and at the end of unmodified therapy (59% versus 62%). Gram-positive bacteremia responded poorly in the meropenem and ceftazidime/amikacin group (29% versus 25%), whereas all gram-negative bacteremias responded except for one in the meropenem group caused by Pseudomonas aeruginosa. All patients survived to 72 h. One patient in each group died of gram-positive sepsis resistant to study medication. No significant side effects occurred in any regimen. This study su...Continue Reading

Citations

Apr 23, 2009·The Journal of Antimicrobial Chemotherapy·Keith J Williams
Feb 19, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Walter T HughesLowell S Young
Jan 6, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Alison G Freifeld Infectious Diseases Society of Americaa
Jan 25, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Alison G Freifeld Infectious Diseases Society of America
Dec 20, 2007·Pediatric Hematology and Oncology·Kamolwish LaoprasopwattanaMalai Wongchanchailert
Jul 16, 2005·Pediatric Hematology and Oncology·Judit MüllerGábor Kovács
Apr 2, 2002·Expert Opinion on Investigational Drugs·Giovanni BonfiglioGiuseppe Nicoletti
Aug 4, 2004·The Lancet Infectious Diseases·Nasia SafdarDennis G Maki
Aug 30, 2001·Critical Care Clinics·A Safdar, D Armstrong
Dec 16, 2004·The Annals of Pharmacotherapy·Robert E ArianoSheryl A Zelenitsky
Jul 1, 2011·The Korean Journal of Internal Medicine·Dong-Gun LeeJung-Hyun Choi
Jan 16, 2013·Therapeutic Drug Monitoring·Lutz BinderPhilip D Walson
Jul 3, 2013·The Cochrane Database of Systematic Reviews·Mical PaulLeonard Leibovici

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