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01 November 2004

Ceftriaxone monotherapy for the treatment of febrile neutropenia in patients with solid tumors: a prospective study of 100 episodes

Emmanuel Chamorey, Nicolas Magne, Cyril Foa, Josiane Otto, Remy Largillier, Michele Viot, Isabelle Benard-Thiery, Antoine Thyss

Med Sci Monit 2004; 10(11): PI119-125 :: ID: 11816

Abstract

Background:Broad-spectrum beta-lactam is the standard therapy for febrile neutropenia (FN) in cancer patients. The aim of our study was to evaluate the treatment of FN by a once-daily administration of ceftriaxone (CFX) alone.Material/Methods: From Jan. 1, 1997 to Dec. 31, 2001 we prospectively analyzed 100 episodes of FN in 94 patients. Inclusion criteria were: fever ? 38.5°C, neutrophil count (NC) 2. The median duration of neutropenia was 3.5 days (range 1–22). Etiology of fever was: 75 of unknown origin (FUO), 6 clinically defined (CDI), and 19 microbiologically documented (MDI). Median CFX treatment duration was 5 days. Successful response was obtained in 87% of cases; no deaths occurred. Treatment efficacy differed between FUO, CDI, and MDI with, respectively, 92.0, 83.3, and 68.4% success rates (p=0.042). Treatment failure was mostly observed in patients with PS?2 (p=0.0001). Among the 13 failures, 4 resolved in less than 4 days with CFX alone and 9 required additional or modified antimicrobial treatment.Conclusions: Considering the marked practical advantages of CFX alone (well-tolerated treatment with minimum side effects, once-daily administration, low cost, and high response rates), this single-agent regimen appears to be a valuable option in treatment of FN in patients with solid tumors.

Keywords: Infection - complications, Infection - microbiology, Neutropenia - microbiology, Aged, 80 and over, Ceftriaxone - therapeutic use, Drug Therapy, Combination - therapeutic use, Infection - microbiology, Injections, Intravenous, Neoplasms - complications, Neutropenia - microbiology

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750