Meropenem monotherapy as an empirical treatment of febrile neutropenia in childhood cancer patients.

Abstract

INTRODUCTION:

Chemotherapy related neutropenia developing in oncologic patients is a significant condition and major cause of morbidity and mortality. Febrile neutropenic attacks without complications can be successfully treated with wide-spectrum anti-pseudomonal cephalosporins or carbapenems.

OBJECTIVE:

We investigated the efficacy and safety of meropenem in the treatment of febrile neutropenia (FN) in children with cancer.

MATERIALS AND METHODS:

Twenty four patients who had a febrile neutropenic episodes followed by initiation of empirical meropenem therapy were included in the study.

RESULTS:

Of all the patients, 13 (54.2%) had solid tumors, while 11 (45.8%) were diagnosed to have acute leukemia. Among all, 7 (29.2%) and 15 (62.5%) infections were identified microbiologically and clinically, respectively. Fever of unknown origin was observed in 2 (8.3%) patients. The mean duration of neutropenia was 7.2 +/- 3.1 (4-14) days in patients with solid tumors, and 9.3 +/- 4.7 (2-17) days in the group with leukemia. This difference was not statistically significant (log rank, p=0.063). Average time of stay in hospital was 10.1 +/- 6.4 (4-21) days for patients with solid tumors, and 15.9 +/- 11.7 (5-37) days for patients with leukemia (log rank, p=0.041). FN duration was observed to be significantly longer in patients with an absolute neutrophil count (ANC) of less than 100/mm3 and even those with an ANC of less than 200/mm3, and in children who were not in remission for the underlying malign disease (p<0.05). While 22 (91.7%) of the patients were discharged from the hospital, 2 (8.3%) died. The success rate of empirical therapy started with meropenem was 87.5%.

CONCLUSION:

Meropenem is effective and safe for treatment of FN in pediatric cancer patients.

• Authors: Fatih Erbey, Ibrahim Bayram, Sema Yilmaz, Atila Tanyeli
• Journal: Asian Pacific journal of cancer prevention : APJCP (Asian Pac J Cancer Prev) Vol. 11 Issue 1 Pg. 123-6 ( 2010) ISSN: 2476-762X [Electronic] Thailand
• PMID: 20593941 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Antineoplastic Agents
• Thienamycins
• Meropenem

Topics

• Adolescent
• Anti-Bacterial Agents (therapeutic use)
• Antineoplastic Agents (adverse effects)
• Child
• Child, Preschool
• Female
• Humans
• Infant
• Male
• Meropenem
• Neoplasms (complications, drug therapy, microbiology)
• Neutropenia (chemically induced, drug therapy)
• Retrospective Studies
• Thienamycins (therapeutic use)
• Treatment Outcome