Results of a newly published study show that initial empiric monotherapy
with the antibiotic meropenem (Merrem) has positive clinical benefits,
is well-tolerated, and is a realistic alternative to standard
combination therapy (ceftazidime plus amikacin) in the treatment
of febrile episodes in neutropenic patients, including those with
persistent, profound neutropenia who are at high risk of infection.
The study was published in a recent issue of Antimicrobial
Agents and Chemotherapy.
Meropenem is a carbapenem antibiotic being developed by Zeneca
Pharmaceuticals. The product's new drug application is currently
under review by the FDA.
The study, conducted by the European Organization for the Research
and Treatment of Cancer-International Antimicrobial Therapy Cooperative
Group (EORTC-IATCG) and Gruppo Italiano Malattie Ematologiche
Maligne dell' Adulto (GIMEMA) Infection Program, involved over
1,000 patients from 41 centers predominantly in Europe. Its aim
was to compare the efficacy and safety of meropenem as monotherapy
to that of ceftazadime plus amikacin for the initial empiric treatment
of febrile episodes in cancer patients with profoundly persistent
A successful clinical outcome was achieved in 56% (270/483) of
the patients who received monotherapy with merepenem, as compared
with 52% (245/475) of the patients given the combination regimen.
The overall incidence of adverse events considered by the investigators
to be drug related was 3.7% (19/516) in patients receiving merepenem
and 6.1% (31/511) in those given the combination.
Overall, monotherapy with merepenem was shown to be as clinically
beneficial as the combination of antibiotics and was well tolerated
in both the adults and a subgroup of children (1 to 16 years old).
Notably, merepenem was well tolerated by the central nervous system
(no seizures were reported) and by the gastrointestinal tract