Meropenem Has Clinical Benefits in Patients With Neutropenia, New Study Shows

Results of a newly published study show that initial empiric monotherapywith the antibiotic meropenem (Merrem) has positive clinical benefits,is well-tolerated, and is a realistic alternative to standardcombination therapy (ceftazidime plus amikacin) in the treatmentof febrile episodes in neutropenic patients, including those withpersistent, profound neutropenia who are at high risk of infection.The study was published in a recent issue of AntimicrobialAgents and Chemotherapy.

Meropenem is a carbapenem antibiotic being developed by ZenecaPharmaceuticals. The product's new drug application is currentlyunder review by the FDA.

The study, conducted by the European Organization for the Researchand Treatment of Cancer-International Antimicrobial Therapy CooperativeGroup (EORTC-IATCG) and Gruppo Italiano Malattie EmatologicheMaligne dell' Adulto (GIMEMA) Infection Program, involved over1,000 patients from 41 centers predominantly in Europe. Its aimwas to compare the efficacy and safety of meropenem as monotherapyto that of ceftazadime plus amikacin for the initial empiric treatmentof febrile episodes in cancer patients with profoundly persistentneutropenia.

A successful clinical outcome was achieved in 56% (270/483) ofthe patients who received monotherapy with merepenem, as comparedwith 52% (245/475) of the patients given the combination regimen.The overall incidence of adverse events considered by the investigatorsto be drug related was 3.7% (19/516) in patients receiving merepenemand 6.1% (31/511) in those given the combination.

Overall, monotherapy with merepenem was shown to be as clinicallybeneficial as the combination of antibiotics and was well toleratedin 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(minimal nausea/vomiting).