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Colegio de Medicina Interna de México.

2017, Number 6

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Med Int Mex 2017; 33 (6)

Comparison of ceftazidime/amikacin vs imipenem in the treatment of neutropenic fever

De la Cruz-Castillejos JC, Hernández-Fernández C, Alegría-Baños J, Heredia-Vázquez DJ, García-Cañas IE, Osorio-Pérez D, Reyes-Cetina IL, Magdaleno-Lara G, Cruz-Rico J, Tejeda-Romero M, Vázquez-Zamora C

Language: Spanish
References: 16
Page: 715-722
PDF size: 432.56 Kb.


ABSTRACT

Background: Neutropenic fever is one of the major complications of cancer treatment and it is an important cause of morbidity and mortality. It occurs in more than 80% of patients with hematologic malignancies during the first cycle of chemotherapy. Treatment consists on broad-spectrum antibiotics with heterogeneous therapeutic responses.
Objective: To determine the average time for disappearance of fever after the administration of the first dose of antibiotics.
Material and Method: A prospective, randomized, double blind study was conducted. Patients were randomized to receive treatment with ceftazidime/amikacin or imipenem for 10 days. A record of temperature and fever was kept. Blood cultures prior to treatment and at 48 hours were taken in case of persistent fever. All blood cultures were recorded for bacterial growth.
Results: Were evaluated 31 patients with ages between 17 and 61 years (mean 33.6 ± 13.9). Fifteen patients received ceftazidime/amikacin (48.4%) and 16 patients imipenem (51.6%). The average time of remission of fever was 11.2 ± 16.3 vs 14.8 ± 9.6 hours (p = 0.6) for the ceftazidime/amikacin and imipenem group, respectively.
Conclusions: There was no difference about the time of clinical improvement among patients treated with imipenem or ceftazidime/ amikacin. Both antimicrobials schemes were equally effective for the treatment of secondary neutropenic fever chemotherapy.


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