A meta-analysis of piperacillin/tazobactam versus cefepime treatment in cancer patients with febrile neutropenia
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 u...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Universidade Federal de Uberlândia
2016-12-01
|
| Series: | Bioscience Journal |
| Subjects: | |
| Online Access: | http://www.seer.ufu.br/index.php/biosciencejournal/article/view/33340 |
| _version_ | 1818914400670580736 |
|---|---|
| author | Zhang Weidong Xiao Chun Zhou Sixin Wang Rui Wang Li Jia Liping Ma Jinqiu Wang Na |
| author_facet | Zhang Weidong Xiao Chun Zhou Sixin Wang Rui Wang Li Jia Liping Ma Jinqiu Wang Na |
| author_sort | Zhang Weidong |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T23:45:47Z |
| format | Article |
| id | doaj.art-bbf86301f3354ad88b51f80f89bdfba9 |
| institution | Directory Open Access Journal |
| issn | 1981-3163 |
| language | English |
| last_indexed | 2024-12-19T23:45:47Z |
| publishDate | 2016-12-01 |
| publisher | Universidade Federal de Uberlândia |
| record_format | Article |
| series | Bioscience Journal |
| spelling | doaj.art-bbf86301f3354ad88b51f80f89bdfba92022-12-21T20:01:19ZengUniversidade Federal de UberlândiaBioscience Journal1981-31632016-12-0132610.14393/BJ-v32n1a2016-3334033340A meta-analysis of piperacillin/tazobactam versus cefepime treatment in cancer patients with febrile neutropeniaZhang Weidong0Xiao Chun1Zhou Sixin2Wang Rui3Wang Li4Jia Liping5Ma Jinqiu6Wang Na7The First Hospital of Qinhuangdao, Qinhuangdao 066000 ChinaDepartment of General Surgery, The General Hospital of The PLA Rocket ForceDepartment of General Surgery, Chinese PeopleThe First Hospital of Qinhuangdao, Qinhuangdao 066000 ChinaThe First Hospital of Qinhuangdao, Qinhuangdao 066000 ChinaThe First Hospital of Qinhuangdao, Qinhuangdao 066000 ChinaThe First Hospital of Qinhuangdao, Qinhuangdao 066000 ChinaThe First Hospital of Qinhuangdao, Qinhuangdao 066000 ChinaFebrile 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.http://www.seer.ufu.br/index.php/biosciencejournal/article/view/33340meta-analysis piperacillin/tazobactamcefepimefebrile neutropeniacancer |
| spellingShingle | Zhang Weidong Xiao Chun Zhou Sixin Wang Rui Wang Li Jia Liping Ma Jinqiu Wang Na A meta-analysis of piperacillin/tazobactam versus cefepime treatment in cancer patients with febrile neutropenia Bioscience Journal meta-analysis piperacillin/tazobactam cefepime febrile neutropenia cancer |
| title | A meta-analysis of piperacillin/tazobactam versus cefepime treatment in cancer patients with febrile neutropenia |
| title_full | A meta-analysis of piperacillin/tazobactam versus cefepime treatment in cancer patients with febrile neutropenia |
| title_fullStr | A meta-analysis of piperacillin/tazobactam versus cefepime treatment in cancer patients with febrile neutropenia |
| title_full_unstemmed | A meta-analysis of piperacillin/tazobactam versus cefepime treatment in cancer patients with febrile neutropenia |
| title_short | A meta-analysis of piperacillin/tazobactam versus cefepime treatment in cancer patients with febrile neutropenia |
| title_sort | meta analysis of piperacillin tazobactam versus cefepime treatment in cancer patients with febrile neutropenia |
| topic | meta-analysis piperacillin/tazobactam cefepime febrile neutropenia cancer |
| url | http://www.seer.ufu.br/index.php/biosciencejournal/article/view/33340 |
| work_keys_str_mv | AT zhangweidong ametaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT xiaochun ametaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT zhousixin ametaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT wangrui ametaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT wangli ametaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT jialiping ametaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT majinqiu ametaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT wangna ametaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT zhangweidong metaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT xiaochun metaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT zhousixin metaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT wangrui metaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT wangli metaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT jialiping metaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT majinqiu metaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia AT wangna metaanalysisofpiperacillintazobactamversuscefepimetreatmentincancerpatientswithfebrileneutropenia |