Ph. Chandrasekar et Pm. Arnow, Cefepime versus ceftazidime as empiric therapy for fever in neutropenic patients with cancer, ANN PHARMAC, 34(9), 2000, pp. 989-995
OBJECTIVE: To compare the efficacies of cefepime and ceftazidime as empiric
therapy during the management of fever in cancer patients with chemotherap
y-induced neutropenia.
METHODS: A prospective, double-blind, randomized study of cefepime 2 g ever
y eight hours and ceftazidime 2 g every eight hours was performed in 276 ad
ult neutropenic (absolute neutrophil count <500/mm(3)) cancer patients with
fever.
RESULTS: Median duration of neutropenia was five days. Sixty-one percent (n
= 188) of the patients were evaluable. Treatment was successful in 57% (58
/101) of cefepime-treated patients and 60% (52/87) of ceftazidime-treated p
atients (95% CI - 18 to 12; p = 0.77). Bacteremic clearance occurred in 71%
(12/17) of cefepime-treated patients and 40% (6/15) of ceftazidime-treated
patients (p = 0.3). Both drugs were well tolerated.
CONCLUSIONS: Cefepime appears to be as effective as ceftazidime in the init
ial treatment of febrile episodes in adult cancer patients with chemotherap
y-associated neutropenia of modest duration.