Randomized controlled trial comparing ciprofloxacin and cefepime in febrile neutropenic patients with hematological malignancies

Abstract

We could not prove the non-inferiority of CPFX in comparison with CFPM for the initial treatment of FN. CFPM remains the standard treatment of choice for FN.

Managing febrile neutropenia in adult cancer patients: an integrative review of the literature

“…This integrative review located a sample of 12 articles (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) which met the inclusion criteria and are presented in Chart 1.…”

“…Regarding the interventions for management of CT-induced FN, there was a prevalence of studies focused on pharmacological treatment (use of empiric ABT in hospital and outpatient settings, adherence to an antimicrobial management protocol and use of prophylactic or non-prophylactic growth factor) (14)(15)(18)(19)(20)(21)(22)(23)(24) and improvement in the diagnostics (association of biomarkers with the MASCC risk index) (17) . Only one study (16) investigated pharmaceutical management in relation to the efficacy of antibiotic dosage and a study which implied that nurses could contribute to the identification of elderly patients who would benefit from prophylactic use of growth factor in order to reduce the occurrence of FN (13) .…”

“…When comparing efficacy between cefepime and ciprofloxacin, a study recommended that cefepime be used as the initial standard treatment of choice for FN and ciprofloxacin as an empiric and prophylactic treatment. Thus, the significant efficacy of cefepime treatment on day 7 of CT has been demonstrated, resulting in a better response in neutrophil counts of high-risk FN patients (23) . It should be emphasized that the rational use of antimicrobial therapy has a favorable effect on FN management, while reducing hospital costs and lowering mortality rates.…”

“…Data collection of primary articles (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) included in the integrative review was made possible through an instrument detailing: identification of the original article (title, periodical, authors, specialism of authors, year of publication); objective(s); methodological characteristics of the study (type, sample, specialism of the professionals involved in FN management); intervention for FN management; and main findings, conclusions and identification of limitations and/or biases. For the analysis and synthesis of these articles, we used synoptic tables (11) containing: title, author/year and professional category; interventions realized; results; and recommendations/conclusions.…”

Efficacy of oral levofloxacin monotherapy against low-risk FN in patients with malignant lymphoma who received chemotherapy using the CHOP regimen

“…evaluated the efficacy of CFPM in patients with FN whose median age was 61 in a randomized controlled trial, and efficacy was noted in 19/25 (76.0%). 20 Regarding oral fluoroquinolone monotherapy, Chamilos et al . demonstrated that moxifloxacin was effective for 50/55 (91%) outpatients with a median age of 62 years.…”