Piperacillin-tazobactam in pediatric cancer patients younger than 25 months: a retrospective multicenter survey.

Abstract

Piperacillin-Tazobactam (Pip-Taz) is an evidence-based empirical treatment of febrile neutropenia in adolescents and adults. No data are available in pediatric cancer patients <25 months of age. In this retrospective, multicenter data survey, the analysis focuses on safety, tolerance, and efficacy. The daily dose administered was 240 mg/kg given in three equally divided doses. Data on 156 Pip-Taz treatment courses in 69 children <25 months from five pediatric cancer treatment centers (2001-2005) were analyzed. The median duration of treatment with Pip-Taz was 5 days (range, 1-23 days; 1-12 Pip-Taz courses per patient). Pip-Taz was started on the first day of fever in 90% of all courses, in 6% in the first 72 h, and in 4% as second- or third-line agent. Forty-five percent of all patients were neutropenic. In all patients, the outcome was favorable independent whether Pip-Taz was given as monotherapy (42 courses; 27%) or in combination. Overall, Pip-Taz was well tolerated and discontinued due to adverse events in only two patients who experienced non-life-threatening allergic reactions (skin rash and wheezing). The results of this study are preliminary due to the methodological limitations of a retrospective survey. Taking this bias into consideration, Pip-Taz appears to be a safe, and feasible alternative in pediatric cancer patients with febrile neutropenia <25 months of age suggesting that the inclusion of children of all age groups in future prospective controlled studies evaluating Pip-Taz is justified.

• Authors: A Simon, T Lehrnbecher, U Bode, A H Groll, L Tramsen, R Wieland, E Molitor, G Fleischhack, H J Laws
• Journal: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology (Eur J Clin Microbiol Infect Dis) Vol. 26 Issue 11 Pg. 801-6 (Nov 2007) ISSN: 0934-9723 [Print] Germany
• PMID: 17786491 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Piperacillin, Tazobactam Drug Combination
• Penicillanic Acid
• Piperacillin

Topics

• Bacterial Infections (drug therapy)
• Fever of Unknown Origin (drug therapy)
• Humans
• Hypersensitivity
• Infant
• Infant, Newborn
• Neoplasms (complications)
• Neutropenia
• Penicillanic Acid (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Piperacillin (administration & dosage, adverse effects, therapeutic use)
• Piperacillin, Tazobactam Drug Combination
• Retrospective Studies
• Treatment Outcome
• Withholding Treatment