Imipenem compared with ceftazidime plus vancomycin as initial therapy for fever in neutropenic children with cancer

Pediatr Infect Dis J. 1991 Dec;10(12):918-23. doi: 10.1097/00006454-199112000-00008.


Two antibiotic regimens were assessed, imipenem as monotherapy and ceftazidime plus vancomycin as combination therapy, for initial empiric therapy in febrile neutropenic children with cancer. In a prospective randomized trial of 89 evaluable consecutive episodes, 45 were treated with imipenem and 44 with ceftazidime-vancomycin. In 87% of the episodes the neutropenia was severe. Of the 89 episodes 20% were bacteremias, 10% were clinically defined focal infections and 70% were considered fevers of unknown origin. The initial treatment was successful in 82% of the imipenem group and 59% of the ceftazidime plus vancomycin group. Both regimens were well-tolerated. There was no mortality, probably owing to the prompt admission and institution of antimicrobial therapy. All of the patients were treated until neutrophil recovery; no recurrent infections were seen. In conclusion imipenem monotherapy was well-tolerated and effective as initial therapy for fever in neutropenia in children.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Bacterial Infections / complications
  • Ceftazidime / therapeutic use*
  • Child
  • Child, Preschool
  • Drug Evaluation
  • Drug Therapy, Combination / therapeutic use
  • Female
  • Fever / drug therapy*
  • Fever / etiology
  • Humans
  • Imipenem / therapeutic use*
  • Infant
  • Male
  • Neoplasms / complications*
  • Neutropenia / complications*
  • Vancomycin / therapeutic use*


  • Vancomycin
  • Imipenem
  • Ceftazidime