Seventy-three episodes of F&N in 41 pediatric patients between
the ages of 3 and 20 meeting eligibility criteria were randomized
after an initial single dose of IV ceftazidime to receive as outpatients
a) IV ceftazidime every 8 hours or b) oral ciprofloxacin every
12 hours which were continued until the patient was afebrile and
absolute phagocyte count (APC) was rising.1
were monitored at time of presentation for 3-16 hours, then as
an outpatient by daily physical examination, CBC, and observation
of antibiotic administration.
measures included: duration of fever, duration of neutropenia
from presentation, days treated as outpatient, occurrences of
bacteremia, infection, or positive blood cultures, hospitalization,
days hospitalized, ICU admission, and death. No statistically
significant differences were seen between the two treatment arms
in any category.
logistic regression analysis identified duration of neutropenia
(P = 0.0000485), leukemia as underlying malignancy (P = 0.0255),
and temperature in the clinic (P = 0.0158) to be statistically
significant factors associated with hospitalization. However,
presentation APC <100 (P = 0.058), presentation ANC < 100
(P = 0.153), and antibiotic assignment (P = 0.0737) were not.
stepwise multiple regression analysis of the correlation of hospitalization
to duration of neutropenia, leukemia as underlying disorder, ANC
and APC was conducted. Only duration of neutropenia had a statistically
significant correlation to hospitalization (P = 0.00125).
patient in either treatment arm suffered serious complications