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Piperacillin-tazobactam in pediatric cancer patients younger than 25 months: a retrospective multicenter survey

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Abstract

Piperacillin-Tazobactam (Pip-Taz) is an evidence-based empirical treatment of febrile neutropenia in adolescents and adults. No data are available in pediatric cancer patients <25 months of age. In this retrospective, multicenter data survey, the analysis focuses on safety, tolerance, and efficacy. The daily dose administered was 240 mg/kg given in three equally divided doses. Data on 156 Pip-Taz treatment courses in 69 children <25 months from five pediatric cancer treatment centers (2001–2005) were analyzed. The median duration of treatment with Pip-Taz was 5 days (range, 1–23 days; 1–12 Pip-Taz courses per patient). Pip-Taz was started on the first day of fever in 90% of all courses, in 6% in the first 72 h, and in 4% as second- or third-line agent. Forty-five percent of all patients were neutropenic. In all patients, the outcome was favorable independent whether Pip-Taz was given as monotherapy (42 courses; 27%) or in combination. Overall, Pip-Taz was well tolerated and discontinued due to adverse events in only two patients who experienced non-life-threatening allergic reactions (skin rash and wheezing). The results of this study are preliminary due to the methodological limitations of a retrospective survey. Taking this bias into consideration, Pip-Taz appears to be a safe, and feasible alternative in pediatric cancer patients with febrile neutropenia <25 months of age suggesting that the inclusion of children of all age groups in future prospective controlled studies evaluating Pip-Taz is justified.

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Notes

  1. http://ctep.cancer.gov/forms/CTCAEv3.pdf

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Acknowledgement

The contribution of the study nurses Gertrud Wiszniewsky (Bonn) and Brigitte Remus (Essen) to the data collection is thankfully acknowledged. This study was supported by Wyeth Pharma GmbH, Muenster, Germany. Wyeth Pharma GmbH has no influence on data analysis or submission of this article.

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Authors and Affiliations

  1. Pediatric Hematology/Oncology, Children’s Hospital Medical Centre, University of Bonn, Bonn, Germany

    A. Simon, U. Bode & G. Fleischhack

  2. Pediatric Hematology and Oncology, University of Frankfurt, Frankfurt, Germany

    T. Lehrnbecher & L. Tramsen

  3. Infectious Disease Research Program, Centre for Bone Marrow Transplantation, University Children’s Hospital, Muenster, Germany

    A. H. Groll

  4. Department of Pediatric Hematology and Oncology, University Children’s Hospital, Muenster, Germany

    A. H. Groll

  5. Department of Hematology and Oncology, Children’s Hospital, University of Essen, Essen, Germany

    R. Wieland

  6. Institute for Medical Microbiology, Immunology and Parasitology, University of Bonn, Bonn, Germany

    E. Molitor

  7. Clinics of Pediatric Oncology, Hematology and Immunology, University of Duesseldorf, Duesseldorf, Germany

    H. J. Laws

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  1. A. Simon
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  2. T. Lehrnbecher
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  3. U. Bode
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  8. G. Fleischhack
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Correspondence to A. Simon.

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Simon, A., Lehrnbecher, T., Bode, U. et al. Piperacillin-tazobactam in pediatric cancer patients younger than 25 months: a retrospective multicenter survey. Eur J Clin Microbiol Infect Dis 26, 801–806 (2007). https://doi.org/10.1007/s10096-007-0382-5

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  • DOI: https://doi.org/10.1007/s10096-007-0382-5

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