Ciprofloxacin vs Ceftazidime for Empirical Treatment of High-Risk Neutropenic Fever in Children With Hematologic Malignancies

NCT ID: NCT07016165

Last Updated: 2025-08-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-01

Study Completion Date

2025-12-31

Brief Summary

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This clinical trial will compare use of ciprofloxacin and ceftazidime work in treating high-risk fever in children with hematological malignancies

1. Does ceftazidime work better than ciprofloxacin as a first-choice antibiotic for children with hematological malignancies who have high-risk fever from low neutrophil count?
2. Are there any specific factors that affect how children with hematological malignancies respond to ciprofloxacin or ceftazidime when treating high-risk fever?

Participants in this study are children with hematological malignancies who have a high risk of fever due to low neutrophil count. Children, aged 0 to 18 years old, will be hospitalized between June and December 2025 at Sardjito General Hospital

The study will involve:

* Collecting patient history, conducting physical exams, and performing supporting tests.
* Randomly assigning participants into two groups: one group will receive the standard treatment with intravenous ciprofloxacin, while the other group will receive the intervention treatment with intravenous ceftazidime.
* Both groups will be monitored for various outcomes, including the length of fever, length of low white blood cell count, length of hospital stay, length of antibiotic use, any changes in antibiotics, and mortality.

Detailed Description

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Furthermore, this clinical trial aims to:

1. Compare the efficacy of empirical antibiotic administration of Ciprofloxacin and Ceftazidime in pediatric malignancy patients with high-risk neutropenic fever.
2. Analyze the differences in clinical effectiveness between ceftazidime and ciprofloxacin antibiotics based on the duration of fever, duration of neutropenia, duration of hospitalization in high-risk neutropenic fever in children with hematological malignancies.
3. Compare the mortality of pediatric patients with high-risk neutropenic fever due to hematological malignancies who received empirical antibiotic therapy of ceftazidime and ciprofloxacin.
4. Compare antibiotic escalation decisions in pediatric patients with high-risk neutropenic fever due to hematological malignancies who received empirical antibiotic therapy of ceftazidime and ciprofloxacin.

Conditions

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Neutropenic Fever Acute Lymphoblastic Leukemia Acute Myeloblastic Leukemia Non Hodgkin Lymphoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group A

Standard therapy IV ciprofloxacin 10 mg/kgBW/12 hours

Group Type ACTIVE_COMPARATOR

Ciprofloxacin

Intervention Type DRUG

Ciprofloxacin 10 mg/kgBW/12 hours

Group B

IV ceftazidime 150 mg/kgBW/24 hours divided into 3 doses

Group Type EXPERIMENTAL

Ceftazidime

Intervention Type DRUG

Ceftazidime 150 mg/kgBW/24 hours divided into 3 doses.

Interventions

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Ceftazidime

Ceftazidime 150 mg/kgBW/24 hours divided into 3 doses.

Intervention Type DRUG

Ciprofloxacin

Ciprofloxacin 10 mg/kgBW/12 hours

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Children aged 0 to 18 years with hematological malignancies.
* Children with high-risk neutropenic fever, namely children with blood malignancies induction phase ALL, consolidation phase ALL, reinduction phase ALL, relapse ALL; meningeal ALL, AML, and NHL, diagnosed by a competent pediatrician on duty.
* Consent from parents to be included in the study.

Exclusion Criteria

* Children with malignancies but accompanied by comorbidities (HIV infection, septic shock).
* Allergy to ciproloxacin or ceftazidime.
* Fever associated with blood transfusion reactions.
* Receiving other antibiotics since 72 hours before being included in the study, except for cotrimoxazole prophylaxis for the prevention of Pneumocystis carinii pneumonia, and ciproloxacin prophylaxis in AML.
* Children with blood malignancies who have impaired renal function (serum creatinine ≥ 1.5 times the upper normal limit) and impaired liver function (SGPT \> 5 times the upper normal limit).
Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gadjah Mada University

OTHER

Sponsor Role lead

Responsible Party

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Bambang Ardianto

Principal Investigator, Head of Pediatric Hematolo-Oncology Divison

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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RSUP dr Sardjito

Sleman, DI Yogyakarta, Indonesia

Site Status RECRUITING

Countries

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Indonesia

Central Contacts

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dr. Khairunisa Rahma Handayani, Medical doctor

Role: CONTACT

+6281246572652

Facility Contacts

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dr. Amanda Sari Puspita, Pediatric resident

Role: primary

+62 821-8300-4177

References

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Corapcioglu F, Sarper N. Cefepime versus ceftazidime + amikacin as empirical therapy for febrile neutropenia in children with cancer: a prospective randomized trial of the treatment efficacy and cost. Pediatr Hematol Oncol. 2005 Jan-Feb;22(1):59-70. doi: 10.1080/08880010590896297.

Reference Type BACKGROUND
PMID: 15770833 (View on PubMed)

Kamonrattana R, Sathitsamitphong L, Choeyprasert W, Charoenkwan P, Natesirinilkul R, Fanhchaksai K. A Randomized, Open-Labeled, Prospective Controlled Study to Assess the Efficacy of Frontline Empirical Intravenous Piperacillin/Tazobactam Monotherapy in Comparison with Ceftazidime Plus Amikacin for Febrile Neutropenia in Pediatric Oncology Patients. Asian Pac J Cancer Prev. 2019 Sep 1;20(9):2733-2737. doi: 10.31557/APJCP.2019.20.9.2733.

Reference Type BACKGROUND
PMID: 31554370 (View on PubMed)

Yasuda T, Suzuki R, Ishikawa Y, Terakura S, Inamoto Y, Yanada M, Nagai H, Ozawa Y, Ozeki K, Atsuta Y, Emi N, Naoe T. Randomized controlled trial comparing ciprofloxacin and cefepime in febrile neutropenic patients with hematological malignancies. Int J Infect Dis. 2013 Jun;17(6):e385-90. doi: 10.1016/j.ijid.2012.12.005. Epub 2013 Jan 11.

Reference Type BACKGROUND
PMID: 23317527 (View on PubMed)

Other Identifiers

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KE/FK/0517/EC/2025

Identifier Type: -

Identifier Source: org_study_id

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