DOI: 10.36347/sjams.2014.v02i06.071

Pages: 3207-3214

Infectious diseases are important causes of morbidity and mortality in patients with cancer. Neutropenia has been recognized form any decades as a major risk factor for the development of infections in cancer patients undergoing chemotherapy. Effective strategies to anticipate, prevent, and manage infectious complications in neutropenic cancer patients have led to improved outcomes. The aim of this study was to compare the efficacy and safety of Cefepime monotherapy versus dual therapy with PIP/TAZO plus Amikacin for empirical treatment of neutropenic fever in children with solid tumors. Data of one hundred and thirty episodes in 80 patients treated with monotherapy as well as one hundred and twenty one episodes in 62 patients treated with dual therapy were analyzed. These episodes occurred in patients with solid tumors who were admitted to the pediatric oncology department at the National Cancer Institute, Cairo University between February 2012 and February 2013. Patients in the monotherapy arm received Cefepime 50 mg/kg/dose every 8 hours. Whereas, those of the dual therapy arm received PIP/TAZO 100mg/kg/dose every 8 hours plus Amikacin 15 mg/kg/day. Modification was defined as addition or shifting to other antimicrobials. Success without modifications was 87.6% & 86.7% in the monotherapy and dual therapy arms; respectively. The incidence of MDROs was lower among the monotherapy arm compared to dual therapy arm (p=0.013).