Retrospective Cohort Study of Clinical Efficacy and Safety of Cefozopran for Treating Febrile Neutropenia during Chemotherapy in Patients with Lung Cancer

Acta Med Okayama. 2022 Apr;76(2):167-172. doi: 10.18926/AMO/63410.

Abstract

Febrile neutropenia (FN) is a serious side effect in patients undergoing cancer chemotherapy and frequently proves fatal. Since infection control is crucial in the management of FN, the antimicrobial agent cefozopran (CZOP) has been recommended but not approved for routine use in clinical care of FN in Japan. However, few studies of CZOP in the management of FN have used a thrice daily dose schedule. The aim of this study was to retrospectively compare the efficacy and safety of CZOP at a dose of 1 g three times daily to those of cefepime (CFPM) in the treatment of FN in our lung cancer patients. The response rates of the CZOP and CFPM groups were 89.5% (17/19 cases) and 83.0% (39/47 cases), respectively, with no significant difference between the two groups. The median duration of antimicrobial treatment was 6 days (4-10 days) in the CZOP group and 7 days (3-13 days) in the CFPM group, with no significant difference between groups. The incidence rates of adverse events were 21.1% (4/19 cases) in the CZOP group and 19.1% (9/47 cases) in the CFPM group. No adverse events of Grade 3 or higher were observed in either group. The findings of the present study suggest that CZOP administration at a dose of 1 g three times per day as an antimicrobial treatment alternative against FN.

Keywords: cefepime; cefozopran; febrile neutropenia; lung cancer; retrospective.

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Cefepime / adverse effects
  • Cefozopran
  • Cephalosporins / adverse effects
  • Febrile Neutropenia* / chemically induced
  • Febrile Neutropenia* / drug therapy
  • Humans
  • Lung Neoplasms* / drug therapy
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Cefepime