Monotherapy versus dual therapy based on risk categorization of febrile neutropenic patients

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Kazuma Ohyashiki

Abstract

Cefepime monotherapy was compared with cefepime-plus-amikacin dual therapy for treatment of febrile neutropenic patients. Response rates were significantly lower for patients receiving monotherapy who had neutrophil counts of <500 cells/mm3 but did not differ significantly between patients receiving dual therapy who had neutrophil counts of > or =500 cells/mm3 or <500 cells/mm3. Dual therapy is recommended for the initial treatment of patients with neutropenia with <500 cells/mm3. Dual therapy was significantly more effective in patients with neutropenia lasting <5 days. The response rates to monotherapy or dual therapy did not differ significantly when neutropenia persisted for > or =6 days, indicating that sustained neutropenia is a risk factor for failure of initial empirical therapy. The rate of response to monotherapy was lower in leukemic patients, whereas the rate of response to dual therapy did not differ between leukemic and nonleukemic groups. The rate of response to either monotherapy or dual therapy did not differ for patients with temperatures of > or =38 degrees C or 37.5 degrees C-38 degrees C. Overall, defervescence occurred in >80% of patients with mild infections, whereas only 32% of those with moderate to sev...Continue Reading

References

Feb 19, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Walter T HughesLowell S Young
Nov 26, 2002·American Journal of Hematology·K TamuraUNKNOWN Kyushu Hematology Organization for Treatment (K-HOT) Study Group
Jul 14, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·K TamuraUNKNOWN Japan Febrile Neutropenia Study Group
Jul 14, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·K Tamura

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Citations

Jun 17, 2010·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Shin AhnKyoo-Hyung Lee
Jul 14, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Juan J Picazo
Jul 1, 2011·The Korean Journal of Internal Medicine·Dong-Gun LeeJung-Hyun Choi

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