A comparative study of cefepime versus ceftazidime as empiric therapy of febrile episodes in neutropenic patients

An open-label, randomized comparative study was conducted to evaluate the e fficacy and safety of cefepime (2.0 g q. 8 h) and ceftazidime (2.0 g q. 8 h ) in the empiric therapy of febrile neutropenic patients. A total of 45 eli gible febrile episodes were randomized (1:1) to be treated with the study r egimen. Nineteen febrile episodes treated with cefepime and 22 febrile epis odes treated with ceftazidime were evaluable for efficacy. The two groups w ere comparable in terms of age, sex, height, weight, underlying neoplasm, n umber of pretherapy neutrophil, duration of neutropenia and types of infect ions. The overall therapeutic success rate of the cefepime group (53%) was comparable to the ceftazidime group (50%). It did not differ significantly (95% confidence interval: -0.28 to 0.34, p = 0.85). Eighty-eight percent of pathogens in each group were bacteriologically eradicated. The safety prof ile was similar in both groups. No patients in either group discontinued th e therapy because of adverse events. None (0%) of the cefepime patients and 2 (9%) of the ceftazidime patients died of infection. The results of this study suggest that cefepime is an effective and safe agent in the empiric t herapy of febrile episodes in neutropenic patients.