Clinical efficacy and safety of cefepime in febrile neutropenic patients with lung cancer

Fujita, Masaki; Okumura, Hiroshi; Inoue, Yuichi; Inoshima, Ichiro; Ohshima, Tsukasa; Yoshimura, Chikara; Wataya, Hiroshi; Kawasaki, Masayuki; Shoji, Tetsuo; Nakanishi, Yoichi

doi:10.1007/s10156-010-0030-3

Cited by 9 publications

(4 citation statements)

References 18 publications

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“…[70][71][72] Cefepime, for example, has been extensively studied in patients with febrile neutropenia and is widely considered a first-line drug for empiric therapy. [73][74][75] Still, it is conceivable that patients with febrile neutropenia are at risk for acquisition of MDR gram-negative organisms because of immunosuppression, repeated hospital admissions, previous exposure to antibiotics, previous colonization or infection with a resistant pathogen, local hospital epidemiology, and presence of intravascular devices. At a minimum, factors associated with acquisition of MDR gramnegative bacilli should be considered before starting empiric monotherapy.…”

Section: Adequate Initial Activitymentioning

confidence: 99%

Combination Antibiotic Therapy for Empiric and Definitive Treatment of Gram‐Negative Infections: Insights from the Society of Infectious Diseases Pharmacists

Boyd

Nailor

2011

Pharmacotherapy

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The widespread emergence of antibiotic-resistant gram-negative organisms has compromised the utility of current treatment options for severe infections caused by these pathogens. The rate of gram-negative multidrug resistance is worsening, threatening the effectiveness of newer broad-spectrum antibiotic agents. Infections associated with multidrug-resistant Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacteriaceae are having a substantial impact on hospital costs and mortality rates. The potential for these resistant gram-negative nosocomial pathogens must always be a primary consideration when selecting antibiotic therapy for critically ill patients. Empiric combination therapy directed at gram-negative pathogens is a logical approach for patients with suspected health care-associated infections, particularly those with risk factors for infections caused by multidrug-resistant pathogens. Although in vitro synergy tests have shown potential benefits of continued combination therapy, convincing clinical data that demonstrate a need for combination therapy once susceptibilities are known are lacking. Thus, deescalation to a single agent once susceptibilities are known is recommended for most patients and pathogens. Use of polymyxins, often in combination with other antimicrobials, may be necessary for salvage therapy.

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Section: Adequate Initial Activitymentioning

confidence: 99%

Combination Antibiotic Therapy for Empiric and Definitive Treatment of Gram‐Negative Infections: Insights from the Society of Infectious Diseases Pharmacists

Boyd

Nailor

2011

Pharmacotherapy

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“…If the severity of illness and CRP can be used to predict whether the FN will be refractory, then these patients can be treated more successfully by an agent which is most likely to provide a cure (broad-spectrum antibiotics including carbapenem). The other patients whose infection should respond to conventional agents should be treated with other drugs to prevent the development of bacteria resistant to broad-spectrum antibiotics including carbapenem [15,16]. However, the superiority of carbapenem has not been confirmed in this study.…”

Section: Discussionmentioning

confidence: 92%

Identifying risk factors for refractory febrile neutropenia in patients with lung cancer

Fujita

Shoji

Ikegame

et al. 2012

Journal of Infection and Chemotherapy

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“…What type of antimicrobial agent should be used is yet to be determined. We investigated the role of intravenous antibiotics in FN in patients with lung cancer in past (9) , (10) , (11) . We currently investigated the role of oral antibiotics, STFX in low-risk FN patients with lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Sitafloxacin in Treating Low-risk Febrile Neutropenia in Patients with Lung Cancer

Matsumoto

Ebi

et al. 2022

JMA J

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Introduction: Febrile episodes in patients with cancer and chemotherapy-induced neutropenia can be life-threatening and generally require prompt administration of broad-spectrum antimicrobials. However, little evidence exists for treating patients with solid tumors and febrile neutropenia (FN) with oral antimicrobials. Methods: In this prospective study, we aimed to determine the efficacy and safety of sitafloxacin (STFX) for treating FN in lung cancer patients. In this prospective study, low-risk FN patients with lung cancer received STFX. The primary endpoint was response rate, defined as 5 sequential days of absence of fever without adverse events. The study was registered as UMIN000010911. Results: As a result, STFX was administered to 26 patients, all of whom survived during its administration. Of the 26, 14 completed primary endpoint (53.85%). The low response rate was attributed to occurrence of fevers of unknown cause rather than failure of FN treatment. Only two patients received antibacterial agents other than STFX. If response rate omitted absence of fever and been defined only as recovery from FN without changing microbial agents or serious complications, the response rate would have been 91.67%. Adverse events occurred in eight patients, none of which were serious. Conclusions: In conclusion, STFX might be used to treat low-risk FN in patients with lung cancer; however, a more detailed study will be required in future.

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Clinical efficacy and safety of cefepime in febrile neutropenic patients with lung cancer

Cited by 9 publications

References 18 publications

Combination Antibiotic Therapy for Empiric and Definitive Treatment of Gram‐Negative Infections: Insights from the Society of Infectious Diseases Pharmacists

Combination Antibiotic Therapy for Empiric and Definitive Treatment of Gram‐Negative Infections: Insights from the Society of Infectious Diseases Pharmacists

Identifying risk factors for refractory febrile neutropenia in patients with lung cancer

Efficacy and Safety of Sitafloxacin in Treating Low-risk Febrile Neutropenia in Patients with Lung Cancer

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