Comparison of clinical outcomes of treatment with cefepime monotherapy vs. amikacin-ceftriaxone combination in children with chemotherapy-induced fever and neutropenia

Background & Aims: Fever and neutropenia are major causes of mortality in cancer patients.This study compares the effectiveness of cefepime monotherapy with a ceftriaxone-amikacin combination in treating these complications. Materials & Methods:In a randomized clinical trial, 60 febrile neutropenic children with cancer at Shahid Motahari Hospital, Urmia, were assigned to receive either cefepime monotherapy or ceftriaxone-amikacin combination therapy.The hospital length of stay, time to defervescence, and frequency of therapy escalation were compared between the two groups. Results:The cefepime group had a shorter hospital stay, fewer febrile episodes, reduced antipyretic use, and less frequent antimicrobial escalation compared to the combination group.No significant differences were observed in laboratory results between admission and discharge in either group. Conclusion:Cefepime monotherapy was significantly more effective than ceftriaxone-amikacin combination therapy in managing fever and neutropenia in pediatric cancer patients.