Clinical Microbiology and Antimicrobial Chemotherapy. 2001; 3(4):339-347
The combination of ceftazidime with an aminoglycoside is a commonly used standard for empiric therapy of febrile neutropenia. A lot of attention is paid to the development of effective monotherapy for the treatment of this condition. One of the most perspective «candidate» for monotherapy is cefepime. We performed a retrospective study of iv cefepime (2 g 3 times per day) monotherapy (19 cases of infection in 15 patients) compare to combination of iv ceftazidime (2 g 3 times per day) with an iv aminoglycoside (22 cases of infection in 20 patients). All patients had prolonged IV grade neutropenia as a result of cytostatic chemotherapy regarding different types of solid and haematologic neoplasm. Overall efficacy was: in cefepime group – 68,5%, in ceftazidime-aminoglycoside group – 40,9% (р=0,07). The modification of antimicrobial therapy was necessary in 42% of cases in cefepime group and 72,7% – in ceftazidime-aminoglycoside group (р=0,04). The mean cost of antimicrobials in cefepime group was 518 (429–606) USD, in ceftazidime-aminoglycoside group – 482 (368–596) USD. In 9% of patients in ceftazidime-aminoglycoside group nephrotoxicity was documented. No toxicity was detected in cefepime group. Results of present study suggest that cefepime monotherapy can be used as an alternative to the standard combination therapy for treatment of the febrile neutropenia.