Meropenem is a promising
carbapenem antibiotic as an empirical monotherapy in patients with
febrile neutropenia (FN). With the limited data of the
therapy in pediatric patients, the authors conducted this study to evaluate the efficacy and safety of
meropenem as empirical
antibiotic therapy in 30 pediatric
cancer patients with FN (mean age = 7.5 years), who were admitted to King Chulalongkorn Memorial Hospital from May 2000 to December 2001.
Meropenem 60 mg/kg/day was given intravenously every 8 hours. The efficacy of
meropenem was assessed as successful, inconclusive and failure on days 3 and 5 of the
therapy and compared to that of other empirical
antibiotics used from January 1997 to April 2000. The study showed that six blood culture specimens (20%) grew organisms, half of which were considered to be contaminants, and six urine culture specimens (20%) grew gram negative rod bacteria. On day 3 and 5 of the
therapy, the success rate of
meropenem was higher than that of comparatives (30.0% vs 17.6% on day 3, 50.0% vs 39.3% on day 5). The use of
meropenem appeared safe, with minimal side effects. In conclusion, the present study showed that
meropenem was safe and tolerable in children. The efficacy as an empirical monotherapy in pediatric
cancer patients with FN was satisfactory, with a failure rate of 23.3 per cent on day 5 of treatment.