Comparison of meropenem with amikacin plus ceftazidime in the empirical treatment of febrile neutropenia: a prospective randomised multicentre trial in patients without previous prophylactic antibiotics

Eighty three patients with neutropenia and cancer were randomised to receiv e either 1 g meropenem tds or amikacin 15 mg/kg single dose daily plus ceft azidime 2 g tds. No prophylactic antibiotics were allowed before entry to t he trial. Seventy seven patients were available for analysis. Infection was microbiologically or clinically documented in 53 episodes (69%). The overa ll success rate without adjustment was 49% in monotherapy, 37.5% in the com bination group. These rates were increased to 65% and 56%, respectively whe n secondary infection episodes requiring a different class of chemotherapy were taken into account. Median duration for defervescence was 3 days in su ccessfully treated patients in both groups. Only minor reversible side effe cts were noted in both treatment arms. Meropenem monotherapy seemed as effe ctive and safe as amikacin plus ceftazidime for the empirical treatment of neutropenic cancer patients with fever. (C) 1999 Published by Elsevier Scie nce B.V. and International Society of Chemotherapy. All rights reserved.