Efficacy and Safety of Piperacillin-Tazobactam and Cefepime as Empirical Therapy for Febrile Neutropenic Children with Acute Lymphoblastic Leukaemia (ALL)

Authors

  • Mehnaz Akter Assistant Professor, Department of Paediatric Haematololgy and Oncology, Dhaka Medical College (DMC), Dhaka, Bangladesh
  • Afiqul Islam Professor & Ex-Chairman, Department of Paediatric Haematololgy and Oncology, BSMMU, Dhaka, Bangladesh
  • Akm Amirul Morshed Additional Director General (Admin), DGME, Professor and Ex- Head of the Department of Paediatric Haematololgy and Oncology, DMC, Dhaka, Bangladesh
  • Zannat Ara Assistant Professor, Department of Paediatric Haematololgy and Oncology, Dhaka Medical College (DMC), Dhaka, Bangladesh
  • SM Rezanur Rahman Assistant Professor, Department of Paediatric Haematololgy and Oncology, Dhaka Medical College (DMC), Dhaka, Bangladesh
  • Md Tanvir Ahmmed Assistant Professor, Department of Paediatric Haematololgy and Oncology, Dhaka Medical College (DMC), Dhaka, Bangladesh
  • Md Bani Yeamin Assistant Professor, Department of Paediatric Haematololgy & Oncology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh

DOI:

https://doi.org/10.3329/bjch.v45i2.60079

Keywords:

Acute lymphoblastic leukaemia (ALL), Febrile neutropenia, Empirical therapy, Efficacy and safety

Abstract

Background: Infection is a major clinical challenge in ALL treatment. Prompt administration of empirical antibiotic in febrile neutropenic patients has reduced the mortality. Both Cefepime or Piperacillin-Tazobactam has been used as empirical treatment.

Objective: To compare the efficacy and safety between Piperacillin-Tazobactam with Cefepime in febrile neutropenic children with ALL.

Materials and methods: This randomized study was conducted from August 2015 to August 2016 in BSMMU. Sixty one episodes of febrile neutropenia in children with ALL, aged 0 to18 years were included in this study. Patients were randomized into two groups. One group received Piperacilln/Tazobactam and another group received Cefepime and data of 60 febrile neutropenic episodes were analyzed.

Results: Febrile neutropenic episodes in the Piperacillin/Tazobactam group were 28 and in Cefepime group was 32 episodes and 34(57.63%) were male and 25 (42.37%) female. Median age was 5 years and 38(62.3%) neutropenic episodes were in induction phase. Majority had fever without focus 21(35%). Microorganisms isolated in 13 (21.66%) patients and majority 6 (46.15%) had blood infection. Most of the isolated organisms were Gram negative 11(84.61%). Overall treatment success without modification in the Piperacillin/Tazobactam group was 17(60.7%) and in Cefepime group 18 (56.3%) and that comparison was not statistically significant (p= 0.732). Significant difference was also not found comparing the mean duration of fever, neutropenia and hospital stay.

Conclusion: Both Piperacillin/Tazobactam and Cefepime were found effective and safe as an empirical therapy for febrile neutropenic children with ALL.

BANGLADESH J CHILD HEALTH 2021; VOL 45 (2) : 83-88

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Published

2022-06-09

How to Cite

Akter, M. ., Islam, A. ., Morshed, A. A. ., Ara, Z. ., Rahman, S. R. ., Ahmmed, M. T. ., & Yeamin, M. B. . (2022). Efficacy and Safety of Piperacillin-Tazobactam and Cefepime as Empirical Therapy for Febrile Neutropenic Children with Acute Lymphoblastic Leukaemia (ALL). Bangladesh Journal of Child Health, 45(2), 83–88. https://doi.org/10.3329/bjch.v45i2.60079

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Original Articles