The effectiveness of empirical monotherapy with cefepime in neutropenic fever

A study by Spanish scientists has shown that empirical monotherapy with cefepime neutropenic fever is effective in patients with malignant blood diseases.

As a rule, β-lactam antibiotics are used to treat neutropenic fever, either as monotherapy or in combination with aminoglycosides. Researchers at the Sant Creu i Sant Pau clinic (Barcelona, Spain) evaluated the efficacy of empirical monotherapy with fourth generation cefepime cefalosporin in 126 episodes of neutropenic fever in 98 adult patients with malignant blood diseases.

Patients received treatment with iv cefepime (2 g, every 8 hours). In 49% of cases, there was a fever of unknown etiology, but the possibility of an infectious process was not excluded. In 25% of cases, it was possible to obtain microbiological confirmation of the infection. Neutropenic fever developed after traditional chemotherapy in 61% of the cases, after a bone marrow transplant in 41%.

Of the 114 episodes of neutropenic fever assessed, a response to cefepime monotherapy was observed in 61% of the cases. Monotherapy proved ineffective in 39% of cases, including 14 cases of fulminant bacteremia. It was not possible to assess the effectiveness of treatment in 12 cases (10%).

During the evaluation of the final results, it turned out that in 69 cases, monotherapy with cefepime was effective, in 47 cases, it was necessary to modify the therapy. During the study period, patient deaths from bacterial infections were not recorded, although 10 patients died from other causes. Prolonged neutropenic fever increased the risk of treatment failure and fulminant bacteremia.

According to the researchers, empirical cefepime monotherapy is effective in patients with malignant blood diseases that occur with neutropenic fever.