Panipenem versus cefepime as empirical monotherapy in adult cancer patients with febrile neutropenia: a prospective randomized trial

Japanese Journal of Clinical Oncology
Ki Tae KwonJae-Hoon Song

Abstract

To compare the efficacy and safety of panipenem/betamipron with cefepime as empirical monotherapy for adult cancer patients with febrile neutropenia, a randomized, open-label, comparative trial was performed. All enrolled patients were randomly assigned to receive either panipenem or cefepime. All febrile episodes were classified as microbiologically defined infection (MDI), clinically defined infection (CDI) or unexplained fever (UF). Clinical responses to antibiotic therapy were defined as success, initial response but regimen modified or failure. A total of 116 patients were enrolled: 55 patients in the panipenem group and 61 patients in the cefepime group. Demographic and clinical characteristics were similar in the two groups (P > 0.05). In the final evaluation, the success rate for the panipenem group (89.1%) was similar to that of the cefepime group (91.8%) (non-inferiority, P = 0.002, 95% confidence interval: -13.48%, 10.35%). Of the 18 bacterial isolates, nine (50%) were gram-positive and nine (50%) were gram-negative. The prevalence of adverse events in the panipenem group (23.6%) were similar to those in the cefepime group (23.0%) (P = 0.93). All of the adverse events were well tolerated and transient. Although large...Continue Reading

Citations

Feb 5, 2010·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Masaki FujitaUNKNOWN Lung Oncology Group in Kyushu (LOGIK)
Dec 4, 2012·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Hiromichi SuzukiHidenori Nakamura
May 19, 2018·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·M PonrajBhanu Prakash
Nov 12, 2010·The Cochrane Database of Systematic Reviews·Mical PaulLeonard Leibovici
Jul 6, 2012·Journal of Fluorescence·Magdalena Makarska-Bialokoz

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