Ceftazidime for neutropenic fevers: is it still an appropriate choice?

Infection continues to rank as a primary cause of treatment-related mortality in patients with cancer. For patients with neutropenic fevers, immediate empiric treatment with antibiotics is standard care. However, which specific antibiotic is best for initial treatment of high-risk patients has been much debated without consensus. Many major health centers use intravenous ceftazidime as first-line therapy for these patients. Yet updates to guidelines published by the Infectious Diseases Society of America and the National Comprehensive Cancer Network suggest that ceftazidime may no longer be an optimal choice. This article reviews the literature regarding ceftazidime therapy for the treatment of high-risk neutropenic patients with fevers. This critical analysis of existing research reveals significant pharmacologic, physiologic, social, and financial implications, and recommendations for further studies are made.