CEFTAZIDIME MONOTHERAPY FOR EMPIRIC TREATMENT OF FEBRILE NEUTROPENIC PATIENTS - A METAANALYSIS

被引:95
作者
SANDERS, JW
POWE, NR
MOORE, RD
机构
[1] JOHNS HOPKINS UNIV,SCH MED,PROGRAM MED TECHNOL & PRACTICE ASSESSMENT,DIV INTERNAL MED,BALTIMORE,MD 21205
[2] JOHNS HOPKINS UNIV,SCH MED,PROGRAM MED TECHNOL & PRACTICE ASSESSMENT,DIV INFECT DIS,BALTIMORE,MD 21205
[3] JOHNS HOPKINS UNIV,PHARMACOEPIDEMIOL PROGRAM,BALTIMORE,MD 21218
关键词
D O I
10.1093/infdis/164.5.907
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Whether ceftazidime monotherapy is equal in efficacy to combination regimens (Comb) for empiric treatment of febrile neutropenic patients was tested using metaanalysis. Published studies and abstracts of ceftazidime trials were identified, their quality assessed, the efficacy data abstracted and pooled, and effects of patient and study characteristics examined. The pooled odds ratio (OR) of failure of ceftazidime for febrile episodes was 1.27 (95% confidence interval [CI]: 0.79-2.03; n = 1077) and for bacteremic episodes was 0.72 (CI, 0.33-1.58; n = 248; OR < 1.0 favors ceftazidime). Results were not significantly affected by type of antibiotic in Comb, age, neutropenia (< 500/mm3), study quality, or combining abstracts. Results indicate that Comb does not offer a significant advantage over ceftazidime. A subgroup of profoundly neutropenic (< 100/mm3) patients could not be assessed, raising the possibility that in this important subgroup monotherapy and Comb may not be equivalent. Use of ceftazidime empirically may require modification based on microbiologic results and clinical course.
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页码:907 / 916
页数:10
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