Comparative Evaluation of Cefepime and Piperacillin-Tazobactam Monotherapy for Febrile Neutropenia in Pediatric Cancer Patients: A Systematic Review and Meta-Analysis

Abstract

Pediatric cancer patients are at a high risk of developing febrile neutropenia (FN), a common and deadly side effect of cancer therapy. To manage febrile neutropenia, this study focuses on evaluating the safety and effectiveness of two empirical monotherapy options: cefepime (CEF) and piperacillin-tazobactam (PIP/TAZO). A systematic literature search was carried out across databases including PubMed and Google Scholar using a variety of terms, including "neutropenia fever," "cancer patients," "piperacillin-tazobactam," and "cefepime”. Initially, 600 records were found overall from these searches. Resulting in 28-article datasets based on eligibility criteria. To assess the methodological rigour and content relevance of the chosen research, systemic and meta-analyses were used. Research on FN by Uygun et al., Corapcioglu et al., Aamir et al., Bow et al., Sano et al., Weidong Z et al., and others has repeatedly shown that PIP/TAZO and CEF monotherapies are safe and effective treatments. The results support PIP/TAZO as a beneficial alternative for pediatric patients, emphasizing the avoidance of side effects associated with multi-drug regimens. This systematic review suggests that PIP/TAZO monotherapy is comparable to Cefepime in safety and efficacy for managing FN in pediatric cancer patients. The findings highlight the potential of PIP/TAZO to reduce mortality and minimize major side effects, making it a viable therapeutic option for higher-risk febrile neutropenia cases.