Effect of meropenem with or without immunoglobulin as second‐line therapy for pediatric febrile neutropenia

Abstract

MEPM is effective and safe for second-line treatment of febrile episodes in neutropenic pediatric patients. Moreover, IVIG is effective for patients with low serum IgG.

Comparison of the Efficacy of Piperacillin/Tazobactam and Meropenem, with or without Intravenous Immunoglobulin, as Second-Line Therapy for Febrile Neutropenia: A Prospective, Randomized Study

“…In the first study, we demonstrated that MEPM was effective and safe as second-line treatment for cases refractory to first-line treatment (cefepime or PIPC/TAZ). The findings obtained also indicated that the combination of IVIG in addition to MEPM was slightly more effective in cases with low serum IgG levels (＜500 mg/dL) than in those with IgG higher than 500 mg/dL [3]. In the second study, PIPC/TAZ was found to be as effective and safe as MEPM when it was used in second-line treatment for cases refractory to first-line MEPM (approximately 50% of cases with MEPM treatment failure were rescued by PIPC/TAZ and vice versa).…”

“…However, limited information is currently available on second-line antibiotic therapy for FN. We previously conducted two prospective studies on second-line antibiotic therapy for FN [3,4]. The first study showed the usefulness of meropenem (MEPM) as second-line antibiotic therapy as well as concomitant intravenous immunoglobulin (IVIG) [3].…”