Randomized trial of oral versus intravenous antibiotics in low-risk febrile neutropenic patients with lung cancer.

Abstract

BACKGROUND:

Neutropenic fever is one of the most serious adverse effects of cancer chemotherapy. Neutropenia may cause a life-threatening bacterial infection. Therefore, febrile neutropenic inpatients are empirically treated with intravenous broad-spectrum antibiotics. Recently, several studies have suggested the presence of low-risk groups among febrile neutropenic patients.

METHODS:

A prospective randomized trial was conducted to compare treatment with oral ciprofloxacin (200 mg) and amoxicillin-clavulanate (375 mg) administered every 8 h against that with intravenous ceftazidime (1 g) administered every 12 h in low-risk febrile neutropenic patients with lung cancer. All patients received chemotherapy and antibiotic therapy while being hospitalized.

RESULTS:

A total of 177 patients with lung cancer agreed to participate in this study prior to undergoing chemotherapy. Among them, a total of 36 neutropenic patients with 42 febrile episodes were enrolled in the study. Treatment was successful without the need for modification in 91% of the episodes in patients receiving the oral regimen and 79% of the episodes in patients receiving the intravenous regimen. No treatment-related deaths occurred. One patient developed nausea while receiving the oral regimen, so the oral regimen was changed to the intravenous regimen in this patient.

CONCLUSIONS:

This prospective study suggested that treatment with oral antibiotics ciplofloxacin plus amoxicillin-clavulanate was effective for low-risk febrile neutropenic patients after chemotherapy.

• Authors: Seiji Niho, Yuichiro Ohe, Koichi Goto, Hironobu Ohmatsu, Taketoshi Matsumoto, Kaoru Kubota, Ryutaro Kakinuma, Yutaka Nishiwaki
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 34 Issue 2 Pg. 69-73 (Feb 2004) ISSN: 0368-2811 [Print] England
• PMID: 15067098 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Infective Agents
• Ciprofloxacin
• Amoxicillin-Potassium Clavulanate Combination
• Ceftazidime

Topics

• Administration, Oral
• Aged
• Amoxicillin-Potassium Clavulanate Combination (administration & dosage)
• Anti-Infective Agents (administration & dosage)
• Ceftazidime (administration & dosage)
• Ciprofloxacin (administration & dosage)
• Drug Therapy, Combination (administration & dosage)
• Female
• Fever (drug therapy)
• Humans
• Infusions, Intravenous
• Lung Neoplasms (drug therapy)
• Male
• Middle Aged
• Neutropenia (chemically induced, complications)
• Prospective Studies
• Treatment Outcome