Efficacy and Safety of Meropenem as an Empirical Treat
ment for Febrile Neutropenia in Children with Cancer
CHITSANU PANCHAROEN, MD*, JUTARAT MEKMULLICA, MD*,
JIRANUN BURANACHONAPA, MD**, DUANGJAI TRONGJIT, MD**,
ISSARANG NUCHPRA YOON, MD***, PREEDA VA NICHSET AKUL, MD***,
PANY A SEKSARN, MD***, USA THISYAKORN, MD*
Affiliation : * Infectious Disease Unit,
** Pediatric Resident,
*** Hematology and Oncology Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkom University, Bangkok
10330, Thailand.
AbstractMeropenem is a promising carbapenem antibiotic as an empirical monotherapy in patients
with febrile neutropenia (FN). With the limited data of the therapy in pediatric patients, the authors
conducted this study to evaluate the efficacy and safety of meropenem as empirical antibiotic therapy
=
in 30 pediatric cancer patients with FN (mean age 7.5 years), who were admitted to King Chula
longkom Memorial Hospital from May 2000 to December 2001. Meropenem 60 mglkg/day was given
intravenously every 8 hours. The efficacy of meropenem was assessed as successful, inconclusive and
failure on days 3 and 5 of the therapy and compared to that of other empirical antibiotics used from
January 1997 to April 2000. The study showed that six blood culture specimens (20%) grew organisms,
half of which were considered to be contaminants, and six urine culture specimens (20%) grew gram
negative rod bacteria. On day 3 and 5 of the therapy, the success rate of meropenem was higher than
that of comparatives (30.0% vs 17.6% on day 3, 50.0% vs 39.3% on day 5). The use of meropenem
appeared safe, with minimal side effects. In conclusion, the present study showed that meropenem was
safe and tolerable in children. The efficacy as an empirical monotherapy in pediatric cancer patients
with FN was satisfactory, with a failure rate of 23.3 per cent on day 5 of treatment.
Keywords : Meropenem, Febrile Neutopenia, Children
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