Meropenem versus ceftazidime as empirical monotherapy for febrile neutropenic cancer patients

A total of 101 cancer patients with 121 febrile neutropenia episodes were r andomised to receive empirical treatment with i.v. meropenem (1 g/8 h) or c eftazidime (2 g/8 h). After 3 days, 89% of patients were on unmodified ther apy in the meropenem group, compared with 83% in the ceftazidime group. Of the evaluable episodes (n = 106), the success rate with unmodified empirica l therapy until the end of the treatment course was slightly higher with me ropenem than with ceftazidime (48% vs 38%, P = 0.39). Furthermore, initial success with further infections was observed in 22% of episodes treated wit h meropenem and in 13% of episodes treated with ceftazidime. Glycopeptides were used as first modification in 28% and 39% of meropenem and ceftazidime recipients, respectively. Both treatments were well tolerated and there we re no reports of drug-related nausea/vomiting or seizures. No significant d ifferences in response rate or in tolerability were observed when analysing only the first febrile episodes. In conclusion, meropenem seems to be as e fficacious and well tolerated as ceftazidime and may be associated with a l esser requirement for the addition of glycopeptides.