Ceftriaxone alone or in combination with antibiotics in the management of infection in cancer patients. A review of 41 clinical trials involving 7350 patient-episodes

Empirical therapy with a broad-spectrum β-lactam and an aminoglycoside is the cornerstone of the management of patients with granulocytopenia and fever. These regimens are able to considerably lower mortality associated with serious infections; however, the optimal management of fever in these 'difficult to treat' patients remains controversial, with other factors such as cost-effectiveness becoming ever more important. The ideal antibiotic regimen for serious infections in cancer patients must therefore be effective in serious infections, but not be too expensive or inconvenient to use. This paper considers the evolution of this therapeutic intervention and reviews the opportunities available for once-daily therapy in treating infections associated with febrile neutropenia, with particular emphasis on the third generation cephalosporin, ceftriaxone. Ceftriaxone has highly favourable pharmacokinetics (half-life of 8 hours), which allow once-daily dosage regimens to be employed even in the most severe infections associated with cancer therapy.