Cefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison
Autor(a) principal: | |
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Data de Publicação: | 2009 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/11600/44508 http://www.ejmii.com/issue_abstract.php?code=PDT4b0cce7d090c6 |
Resumo: | Background and purpose: The empirical use of antibiotic therapy is widely accepted for patients with fever and neutropenia during cancer chemotherapy. The use of intravenous monotherapy with broad-spectrum antibiotics in patients at high risk for complications is an appropriate alternative. However, few data are available for pediatric patients. The aim of this study was to compare the efficacy and safety of cefepime (CFP) monotherapy with ceftriaxone plus amikacin (CFT+AK) in children and adolescents with febrile neutropenia (FN).Methods: A prospective randomized open study of patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy was conducted. Patients were randomized to receive UP or CFT+AK. The randomization was based on number lists.Results: Fifty seven patients with 125 episodes of fever and neutropenia were evaluated (CFP, 62 episodes; CFT+AK, 63 episodes). The mean neutrophil count at admission to hospital was 118.6 cells/mm(3) for patients in the CFP group and 107 cells/mm(3) for patients in the CFT+AK group. The mean duration of neutropenia was 9 days for the UP group and 8 days for the CFT+AK group. Analysis of only the first episodes for each patient showed that UP treatment was successful for 65.5% of episodes and CFT+AK was successful for 64.3% of episodes. The overall rates of success with modification were 90% for the UP group and 89% for the CFT+AK group. No major treatment-emergent toxicity was reported.Conclusion: Monotherapy with UP seems to be as effective and safe as CFT+AK for initial empirical therapy in children and adolescents with FN. |
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Pires Pereira, Carlos Alberto [UNIFESP]Petrilli, Antonio Sergio [UNIFESP]Carlesse, Fabianne AltrudaVercillo Luisi, Flavio AugustoTorres Barros da Silva, Katia VeronicaMartino Lee, Maria Lucia deUniversidade Federal de São Paulo (UNIFESP)2018-06-15T18:07:28Z2018-06-15T18:07:28Z2009-04-01Journal Of Microbiology Immunology And Infection. Taipei: Scientific Communications Int Ltd, v. 42, n. 2, p. 141-147, 2009.1684-1182http://repositorio.unifesp.br/11600/44508http://www.ejmii.com/issue_abstract.php?code=PDT4b0cce7d090c6WOS:000271205800007Background and purpose: The empirical use of antibiotic therapy is widely accepted for patients with fever and neutropenia during cancer chemotherapy. The use of intravenous monotherapy with broad-spectrum antibiotics in patients at high risk for complications is an appropriate alternative. However, few data are available for pediatric patients. The aim of this study was to compare the efficacy and safety of cefepime (CFP) monotherapy with ceftriaxone plus amikacin (CFT+AK) in children and adolescents with febrile neutropenia (FN).Methods: A prospective randomized open study of patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy was conducted. Patients were randomized to receive UP or CFT+AK. The randomization was based on number lists.Results: Fifty seven patients with 125 episodes of fever and neutropenia were evaluated (CFP, 62 episodes; CFT+AK, 63 episodes). The mean neutrophil count at admission to hospital was 118.6 cells/mm(3) for patients in the CFP group and 107 cells/mm(3) for patients in the CFT+AK group. The mean duration of neutropenia was 9 days for the UP group and 8 days for the CFT+AK group. Analysis of only the first episodes for each patient showed that UP treatment was successful for 65.5% of episodes and CFT+AK was successful for 64.3% of episodes. The overall rates of success with modification were 90% for the UP group and 89% for the CFT+AK group. No major treatment-emergent toxicity was reported.Conclusion: Monotherapy with UP seems to be as effective and safe as CFT+AK for initial empirical therapy in children and adolescents with FN.Univ Fed Sao Paulo, Inst Oncol Pediat, Escola Paulista Med, Grp Apoio Crianca Com Canc, BR-04023062 Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Infect Dis, BR-04023062 Sao Paulo, BrazilUniv Fed Sao Paulo, Inst Oncol Pediat, Escola Paulista Med, Grp Apoio Crianca Com Canc, BR-04023062 Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Infect Dis, BR-04023062 Sao Paulo, BrazilWeb of Science141-147engScientific Communications Int LtdJournal Of Microbiology Immunology And InfectionCefepimeLeukemiaLymphomaNeutropeniaRiskCefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparisoninfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/445082022-02-08 11:52:11.47metadata only accessoai:repositorio.unifesp.br:11600/44508Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:17:50.367490Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Cefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison |
title |
Cefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison |
spellingShingle |
Cefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison Pires Pereira, Carlos Alberto [UNIFESP] Cefepime Leukemia Lymphoma Neutropenia Risk |
title_short |
Cefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison |
title_full |
Cefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison |
title_fullStr |
Cefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison |
title_full_unstemmed |
Cefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison |
title_sort |
Cefepime monotherapy is as effective as ceftriaxone plus amikacin in pediatric patients with cancer and high-risk febrile neutropenia in a randomized comparison |
author |
Pires Pereira, Carlos Alberto [UNIFESP] |
author_facet |
Pires Pereira, Carlos Alberto [UNIFESP] Petrilli, Antonio Sergio [UNIFESP] Carlesse, Fabianne Altruda Vercillo Luisi, Flavio Augusto Torres Barros da Silva, Katia Veronica Martino Lee, Maria Lucia de |
author_role |
author |
author2 |
Petrilli, Antonio Sergio [UNIFESP] Carlesse, Fabianne Altruda Vercillo Luisi, Flavio Augusto Torres Barros da Silva, Katia Veronica Martino Lee, Maria Lucia de |
author2_role |
author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Pires Pereira, Carlos Alberto [UNIFESP] Petrilli, Antonio Sergio [UNIFESP] Carlesse, Fabianne Altruda Vercillo Luisi, Flavio Augusto Torres Barros da Silva, Katia Veronica Martino Lee, Maria Lucia de |
dc.subject.eng.fl_str_mv |
Cefepime Leukemia Lymphoma Neutropenia Risk |
topic |
Cefepime Leukemia Lymphoma Neutropenia Risk |
description |
Background and purpose: The empirical use of antibiotic therapy is widely accepted for patients with fever and neutropenia during cancer chemotherapy. The use of intravenous monotherapy with broad-spectrum antibiotics in patients at high risk for complications is an appropriate alternative. However, few data are available for pediatric patients. The aim of this study was to compare the efficacy and safety of cefepime (CFP) monotherapy with ceftriaxone plus amikacin (CFT+AK) in children and adolescents with febrile neutropenia (FN).Methods: A prospective randomized open study of patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy was conducted. Patients were randomized to receive UP or CFT+AK. The randomization was based on number lists.Results: Fifty seven patients with 125 episodes of fever and neutropenia were evaluated (CFP, 62 episodes; CFT+AK, 63 episodes). The mean neutrophil count at admission to hospital was 118.6 cells/mm(3) for patients in the CFP group and 107 cells/mm(3) for patients in the CFT+AK group. The mean duration of neutropenia was 9 days for the UP group and 8 days for the CFT+AK group. Analysis of only the first episodes for each patient showed that UP treatment was successful for 65.5% of episodes and CFT+AK was successful for 64.3% of episodes. The overall rates of success with modification were 90% for the UP group and 89% for the CFT+AK group. No major treatment-emergent toxicity was reported.Conclusion: Monotherapy with UP seems to be as effective and safe as CFT+AK for initial empirical therapy in children and adolescents with FN. |
publishDate |
2009 |
dc.date.issued.fl_str_mv |
2009-04-01 |
dc.date.accessioned.fl_str_mv |
2018-06-15T18:07:28Z |
dc.date.available.fl_str_mv |
2018-06-15T18:07:28Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Journal Of Microbiology Immunology And Infection. Taipei: Scientific Communications Int Ltd, v. 42, n. 2, p. 141-147, 2009. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/11600/44508 http://www.ejmii.com/issue_abstract.php?code=PDT4b0cce7d090c6 |
dc.identifier.issn.none.fl_str_mv |
1684-1182 |
dc.identifier.wos.none.fl_str_mv |
WOS:000271205800007 |
identifier_str_mv |
Journal Of Microbiology Immunology And Infection. Taipei: Scientific Communications Int Ltd, v. 42, n. 2, p. 141-147, 2009. 1684-1182 WOS:000271205800007 |
url |
http://repositorio.unifesp.br/11600/44508 http://www.ejmii.com/issue_abstract.php?code=PDT4b0cce7d090c6 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Journal Of Microbiology Immunology And Infection |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
141-147 |
dc.publisher.none.fl_str_mv |
Scientific Communications Int Ltd |
publisher.none.fl_str_mv |
Scientific Communications Int Ltd |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
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1783460273374363648 |