Cefepime versus ceftazidime as empiric therapy for fever in neutropenic patients with cancer

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.