TY  - JOUR
AU  - Pereira, Carlos Alberto Pires 
AU  - Petrilli, Antonio Sérgio 
AU  - Carlesse, Fabianne Altruda 
AU  - Luisi, Flávio Augusto Vercillo 
AU  - Barros da Silva, Kátia Verônica Torres 
AU  - De Martino Lee, Maria Lúcia 
PY  - 2008
TI  - Cefepime Monotherapy is as Effective as Ceftriaxone Plus Amikacin in Pediatric Patients with Cancer and High-Risk Febrile Neutropenia: A Randomized Comparison
JF  - American Journal of Infectious Diseases
VL  - 4
IS  - 4
DO  - 10.3844/ajidsp.2008.237.243
UR  - https://thescipub.com/abstract/ajidsp.2008.237.243
AB  - The empirical use of antibiotic therapies is widely accepted in patients with fever and neutropenia during cancer chemotherapy. The use of intravenous monotherapy with broad-spectrum antibiotics in patients with high-risk of complications is an appropriate alternative. However, few data are available in pediatric patients. We conducted a prospective, randomized, open study in patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy. Patients were randomized to receive cefepime (CFP) or ceftriaxone plus amikacin (CFT+AK). A total of 57 patients with 125 episodes of fever and neutropenia were evaluated (CFP, 62 and CFT + AK, 63 episodes). The mean neutrophil count at admission was 118.6 cells mm-3 (CFP) and 107 cells mm-3 (CFT+AK). The mean duration of neutropenia was 9.0 days (CFP) and 8.0 days (CFT+AK). Analyzing only the first episodes of each patient, CFP treatment was successful in 65.5% of the episodes and CFT+AK were successful in 64.3%. Overall rates of success with modification were 90% (CFP) and 89% (CFT+AK). No major treatment-emergent toxicity was reported. Monotherapy with CFP seems to be as effective and safe as the combination of CFT+AK for initial empirical therapy in children and adolescents with NF.