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Meropenem versus piperacillin/tazobactam for febrile neutropenia in pediatric patients: efficacy of piperacillin/tazobactam as a 1-h drip infusion four times a day

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Abstract

Although survival of children with hematological diseases and cancer has increased dramatically, febrile neutropenia (FN) is a frequently observed complication and is sometimes life-threatening in pediatric cancer patients. A prospective, randomized study was performed to clarify the usefulness of meropenem (MEPM) and piperacillin/tazobactam (PIPC/TAZ) for pediatric patients with FN. Ninety-nine patients with 394 episodes were randomly assigned to receive MEPM or PIPC/TAZ. MEPM was administered at 120 mg/kg/day as a 1-h drip infusion 3 times a day. On the other hand, PIPC/TAZ was administered at 360 mg/kg/day as a 1-h drip infusion 4 times a day. MEPM was effective in 69.5% of the 200 episodes, and PIPC/TAZ was effective in 77.2% of the 193 episodes. Compared with our previous study of MEPM 120 mg/kg/day as a 1-h drip infusion 3 times a day versus PIPC/TAZ 337.5 mg/kg/day as a 1-h drip infusion 3 times a day, the success rate of the MEPM group was not different. However, the success rate of the PIPC/TAZ group was higher than in the previous study (p = 0.001). In particular, the success rate in patients ≥ 15 years of age was improved in the PIPC/TAZ group of the present study compared with the previous study (p = 0.005).

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Acknowledgements

The authors would like to thank Ms. Yukiko Shiota for data management.

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Authors and Affiliations

  1. Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, 6-6 Higashi-Sapporo, Shiroishiku, Sapporo, 003-0006, Japan

    Ryoji Kobayashi, Hirozumi Sano, Satoru Matsushima, Daiki Hori, Masato Yanagi, Koya Kodama, Daisuke Suzuki & Kunihiko Kobayashi

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  1. Ryoji Kobayashi
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  2. Hirozumi Sano
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  3. Satoru Matsushima
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  4. Daiki Hori
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  5. Masato Yanagi
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  6. Koya Kodama
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  7. Daisuke Suzuki
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  8. Kunihiko Kobayashi
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Correspondence to Ryoji Kobayashi.

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Kobayashi, R., Sano, H., Matsushima, S. et al. Meropenem versus piperacillin/tazobactam for febrile neutropenia in pediatric patients: efficacy of piperacillin/tazobactam as a 1-h drip infusion four times a day. Int J Hematol 113, 430–435 (2021). https://doi.org/10.1007/s12185-020-03031-4

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  • DOI: https://doi.org/10.1007/s12185-020-03031-4

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