A meta-analysis of piperacillin/tazobactam versus cefepime treatment in cancer patients with febrile neutropenia

Authors

  • Zhang Weidong The First Hospital of Qinhuangdao
  • Xiao Chun The General Hospital of The PLA Rocket Force
  • Zhou Sixin Department of General Surgery
  • Wang Rui The First Hospital of Qinhuangdao
  • Wang Li The First Hospital of Qinhuangdao
  • Jia Liping The First Hospital of Qinhuangdao
  • Ma Jinqiu The First Hospital of Qinhuangdao
  • Wang Na The First Hospital of Qinhuangdao

DOI:

https://doi.org/10.14393/BJ-v32n1a2016-33340

Keywords:

Meta-analysis Piperacillin/Tazobactam, cefepime, Febrile neutropenia, cancer

Abstract

Febrile neutropenia (FN) causes a major threat to cancer patients after chemotherapy. Broad-spectrum antibiotic treatment is a well-established practice for febrile neutropenia. Piperacillin/Tazobactam (P/T) is the frequently used antibiotic in most of FN cases, whereas the use of cefepime remains unclear regarding its potential risk. However, little systematic analysis has been conducted about comparison between these two drugs. Thus, we undertook this meta-analysis to compare these two monotherapies for febrile neutropenia. Through searching Pubmed, Google scholar, Medline databases, EMBASE, OvidSP, ScienceDirect, Web of science, and China Journal Net (CJN) databases, we used the keywords "(Piperacillin/Tazobactam AND cefepime) AND (febrile neutropenia) AND (cancer or tumor)". Only studies with randomized controlled trials were included in the meta-analysis. We screened out a total number of seven clinical trials. This meta-analysis supported that P/T treatment was superior to cefepime treatment based on the average OR comparison, without statistical significance (OR = 1.27, 95% confidence interval = 0.98 to 1.64, p = 0.07). We further divided the seven studies into two subgroups based on age and treatment time. The young group (age <= 19) showed no significant difference (OR = 1.10, p = 0.65). While the old group (age > 19) showed that P/T treatment was better than cefepime with statistical difference (OR = 1.44, p = 0.05). The short-term group (time <= 3 ds) showed P/T treatment was better than cefepime with statistical difference (OR = 1.40, p = 0.05). While in the long-term group (time > 5 ds), there was no significant difference between P/T and cefepime therapy (OR = 1.06, p = 0.79) Asymmetry in Funnel plots indicated no publication bias (CHI2 = 1.47, I2=0%, and p-value = 0.96) in this meta-analysis. It would be a good clinical trial to use P/T treatment to cure FN in cancer patients compared with cefepime treatment, especially in adult patients or patients with a short-term treatment period. This meta-analysis is practically important during antibiotic treatment in FN management.

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Published

2016-12-06

How to Cite

WEIDONG, Z., CHUN, X., SIXIN, Z., RUI, W., LI, W., LIPING, J., JINQIU, M. and NA, W., 2016. A meta-analysis of piperacillin/tazobactam versus cefepime treatment in cancer patients with febrile neutropenia . Bioscience Journal [online], vol. 32, no. 6, pp. 1669–1678. [Accessed26 November 2022]. DOI 10.14393/BJ-v32n1a2016-33340. Available from: https://seer.ufu.br/index.php/biosciencejournal/article/view/33340.

Issue

Section

Health Sciences