JARESKO GS, ZAROTSKY V, HOLTOM PD; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2000 Sep 17-20; 40: 474.
Univ. of Southern California, Los Angeles, CA
BACKGROUND: In the cytokine therapy era, bacterial infection continues to be a leading cause of death in FNP. In a number of small studies cefepime has shown comparable results to antipseudomonal beta-lactam regimens. However all of these studies lack the sample size to detect a significant difference. Purpose: Utilizing meta-analysis, we evaluated the relative efficacy of cefepime in FNP.METHODS: A computerized literature search was conducted. Five randomized controlled studies met our inclusion criteria. Comparator regimens included ceftazidime, imipenem, pip+gent. Criteria included evaluation of data for cases that did not require a modification of antibiotic regimen. Data were abstracted independently by two investigators.RESULTS: 1004 cases were identified for analysis. Weighted odds ratios (OR) and 95% confidence intervals (CI) were calculated (OR; CI: # of cases) for the following outcomes: overall clinical cure (0.87; 0.67-1.13:1004) bacteremia (2.20; 0.79-6.20:78), overall mortality (1.47;0.78-2.80:874), mortality due of infection (0.41; 0.13-1.23:89), microbiologic cure (0.75; 0.44-1.29:245), relapse or new bacterial infections (0.73; 0.50-1.09:973), adverse drug reactions (0.64; 0.45-0.92:902), and discontinuation of therapy due to adverse events (1.11; 0.52-2.40:606). When evaluating cefepime vs comparators, gm+ bacteria superinfections comprised 38/57 vs. 33/60 of all superinfections.CONCLUSIONS: In terms of efficacy, there was no difference between cefepime when compared to the other antibiotic regimens. However cefepime did demonstrate significantly less adverse events reported with its use. Gm+ organisms were the predominate superinfection pathogens, suggesting a possible weakness in the evaluated regimens for treating FNP.KEYWORDS: Cefepime; Febrile neutropenia; Meta-analysis
Publication Types:
Keywords:
- Anti-Bacterial Agents
- Bacteremia
- Bacterial Infections
- Ceftazidime
- Cephalosporins
- Humans
- Imipenem
- Meta-Analysis
- beta-Lactams
- cefepime
Other ID:
UI: 102248106
From Meeting Abstracts