Management of Febrile Neutropenia in 396 Episodes in Acute Leukemia Patients with Once-Daily Administration of Ceftriaxone

  • M. Karthaus
  • H.-H. Wolf
  • D. Kämpfe
  • J. Ritter
  • G. Peters
  • H. Jürgens
Part of the Haematology and Blood Transfusion / Hämatologie und Bluttransfusion book series (HAEMATOLOGY, volume 39)



Purpose of this study was to evaluate the efficacy of ceftriaxone in a multicenter non randomized trial as first-line treatment in acute leukemia patients with febrile neutropenia under chemotherapy. Additional antibiotics were added as clinically indicated.

Material and Methods

Patients with a neutrophil count <1000/μl, fever >38.5°C and/or C-reactive-protein (CRP)> 1.0 mg/dl were included. 396 evaluable neutropenic febrile episodes were documented from 38 centers from February 1992 to January 1996. Patients ≤ 15 years of age received 80 mg/kg BW ceftriaxone (max. 4g/d), > 15 years 2g per day. Age distribution was as follows: ≤ 15 years n=158, >15 years n=238. Mean CRP was 5.1 mg% (SD ± 6.0), mean maximum temperature 39.0°C (SD ± 0.7), median Karnofsky-performance score 6.0, mean neutrophil count 368/μl (SD ± 313). In 264 of 396 evaluable episodes (64.9%) FUO was diagnosed. The mean treatment duration was 7.9 days. In 94 episodes initial treatment was with ceftriaxone alone, and combination therapy was given in 302 cases (aminoglycosides+/-glycopeptides).


Response to initial treatment was observed in 205 episodes(51.8%). Nonresponders (n=191) to initial treatment responded to an escalated or alternate antibiotic regimen in 80.6% (n=154). A total of 359 (90.7%) documented responses were obtained.


Ceftriaxone can be considered as a safe and adequate first-line treatment in febrile neutropenia. The addition of glycopeptides or aminoglycosides should be considered in non response or suspected non-sensitive microorganism.


Febrile Neutropenia Acute Leukemia Febrile Episode Febrile Neutropenic Patient Acute Leukemia Patient 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • M. Karthaus
    • 1
  • H.-H. Wolf
    • 2
  • D. Kämpfe
    • 3
  • J. Ritter
    • 4
  • G. Peters
    • 5
  • H. Jürgens
    • 4
  1. 1.Med. KlinikEv.Stift St. Martin, KoblenzGermany
  2. 2.Department of HematologyOtto-von-Goerike Universität MagdeburgGermany
  3. 3.Department of HematologyKKH LüdenscheidGermany
  4. 4.Universitätskinderklinik MünsterGermany
  5. 5.Department of MicrobiologyUniversitätsklinik MünsterGermany

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