***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the therapeutic effects and safety of cefepime ( Maxipime ) and sulbactam/cefoperazone ( sulperazone ) on moderate and severe respiratory infection in children . METHODS Totally 100 children hospitalized for pneumonia were r and omized equally into 2 groups , namely group A with maxipime treatment at the dose of 50 mg/kg given intravenously twice daily , and group B with sulperazone treatment at 50 - 100 mg/kg given intravenously twice a day . The therapeutic effects and safety of both medications were observed . RESULTS In maxipime group , 44 of the 50 cases were cured with complete elimination of the symptoms and signs , and obvious therapeutic effect was achieved in 5 cases with significant improvement or resolution of the majority of symptoms and signs . One case failed to respond favorably to the treatment , with the overall efficacy rate of 98 % without incidence of adverse effects . In sulperazone group , 40 of the 50 cases were cured , 6 showed significant improvement , and 4 failed to respond to the treatment , with the rate of 92 % . One patient complained of rashes during  sulperazone  treatment , which disappeared the next day without sulperazone withdrawal . Significant difference was not noted between the groups ( chi(2)=2.43 , P>0.05 ) . CONCLUSIONS Both maxipime and sulperazon are effective and safe for application in children with moderate and severe respiratory infections BACKGROUND With the availability of new broad-spectrum antibiotics , initial therapy with a single agent has become an alternative to classic combinations , especially beta-lactam antibiotics plus aminoglycosides , in the management of febrile neutropenic cancer patients . PROCEDURE Since January 1994 , monotherapy has been used for empiric initial treatment at our center . The aim of this prospect i ve r and omized study is to compare the efficacy of cefepime ( CFP ) , a new fourth-generation cephalosporin , and ceftazidime ( CFZ ) as empirical monotherapy of febrile neutropenic patients with solid tumors . From January 1998 to November 1998 , 63 episodes of fever and neutropenia occurring in 33 children with solid tumors including lymphomas , were r and omized to receive treatment with either CFP or CFZ . The patients were analyzed for leukocyte count and absolute neutrophil count ( ANC ) at entry , days in fever , neutropenia and hospitalization , and side effects of drugs . Success with or without modifications of the initial antibiotic was defined as survival through neutropenia ; failure was death due to infection . RESULTS In our study group , with a median age of 7 [ (1/12)-14 ] years , CFP was administered in 32 , and CFZ in 31 episodes . An infection was documented microbiologically in eight episodes ( 25 % ) in the CFP arm and in nine episodes ( 29 % ) in the CFZ arm . The success rate with initial empiric monotherapy was 62.5 % in the CFP arm and 61.3 % in the CFZ arm respectively ( P > 0.05 ) . The total success rate ( success with or without modification ) was 100 % in both arms . No major adverse effects were observed in either groups . CONCLUSION CFP is as effective and safe as CFZ for the empirical treatment of febrile episodes in neutropenic patients with solid tumors A prospect i ve , open-label , r and omized , comparative study in pediatric cancer patients was conducted to evaluate the efficacy and safety of cefepime and meropenem in the empiric therapy of febrile neutropenic patients . Febrile episodes were classified as microbiologically documented infection , clinical documented infection , or fever of unknown origin . Clinical response to therapy was classified as success or failure . In this period 37 children with solid tumors including lymphoma , 25 males , 12 females , had neutropenia on 65 occasions . Microbiologically documented infections occurred in 21 episodes ( 32.31 % ) . Frequency of positive bacteria isolated was higher than gram-negative bacteria . There was no infection-related death . There were no statistical differences between the cefepime and meropenem groups for duration of fever or neutropenia , response rate , and necessity for modification . Cefepime appears to be as effective and safe as meropenem for empiric treatment of febrile episodes in neutropenic pediatric cancer patients Background . Monotherapy with cefepime or ceftazidime is an effective alternative to combination therapy for the treatment of febrile neutropenic adult cancer patients . We compared the efficacy and safety of cefepime and ceftazidime as empiric monotherapy of febrile neutropenia in children with cancer . Material s and methods . A prospect i ve , open label , r and omized , comparative study in pediatric cancer patients was conducted at Chang Gung Children ’s Hospital from January 1 , 2000 , to April 15 , 2001 . Patients with fever and neutropenia ( absolute neutrophil count of ≤500/mm3 ) were r and omized to receive either intravenous cefepime or ceftazidime ( 50 mg/kg/dose as two or three doses daily ) . Febrile episodes were classified as microbiologically documented infection , clinical ly documented infection or unexplained fever . Clinical response to therapy was classified as success and failure . Results . Ninety-five pediatric cancer patients with 120 febrile neutropenic episodes were r and omized to receive empiric treatment with cefepime or ceftazidime . After 72 h of treatment , 82.8 % ( 48 of 58 ) of the eligible patients in the cefepime group continued with unmodified therapy , compared with 87.9 % ( 51 of 58 ) in the ceftazidime group . The neutrophil count was < 100/mm3 at r and omization for 76 % of the patients in the cefepime group and 83 % of those in the ceftazidime group ; the median duration s of neutropenia ( < 500/mm3 ) were 8.5 and 6.5 days , respectively . Of the 96 evaluable episodes the overall success rate with unmodified empiric therapy until the end of the treatment course in the cefepime group was comparable with that in the ceftazidime group ( 69%vs . 71 % , P = 0.95 ) . The response rate after glycopeptides were added to the regimens was 79.2 % for the cefepime group and 77.1 % for the ceftazidime group . The bacterial eradication rate was 33 % for the cefepime group and 20 % for the ceftazidime group ( P = 0.85 ) , and the rates of new infections were 10.4%vs . 4.2 % ( P = 0.67 ) , respectively . Both study drugs were well-tolerated . Three ( 6.4 % ) patients in the cefepime group and 2 ( 4.3 % ) patients in the ceftazidime group died . Conclusion . Cefepime appeared to be as effective and safe as ceftazidime for empiric treatment of febrile episodes in neutropenic pediatric cancer patients Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to 9 items in three Delphi rounds . The final criteria list ( the Delphi list ) was satisfactory to all participants . It is a starting point on the way to a minimum reference st and ard for RCTs on many different research topics . This list is not intended to replace , but rather to be used alongside , existing criteria lists Abstract Multidrug-resistant organisms cause late-onset ventilator-associated pneumonia ( VAP ) . In a pilot , r and omized and controlled study , the efficacy and safety of cefepime , in late-onset VAP in infants , have now been evaluated in Malaysia . Thirty children aged < 1 year with late-onset VAP ( i.e. VAP occurring 5 or more days after intubation ) were r and omized to receive cefepime or , as a control , ceftazidime . The clinical responses and the microbiological clearance of tracheal aspirates were evaluated in each arm . Adverse events , if any , were monitored clinical ly and by blood tests . Ten of the 15 children given cefepime and five of the 15 given ceftazidime showed a satisfactory clinical response ( P<0.1 ) . Cefepime appeared significantly better at clearing polymicrobial infections from tracheal aspirates . There were no fatalities in the cefepime arm but three in ceftazidime ( P<0.1 ) . The mean ( S.E. ) duration s of antibiotic use were 9.4 ( 1.5 ) days for cefepime and 7.6 ( 1.0 ) days for ceftazidime ( P>0.05 ) . No serious adverse effects were observed in either arm . In conclusion , in late-onset VAP in infants , cefepime monotherapy appears to be at least as effective and safe as ceftazidime monotherapy , with better microbiological clearance The purpose of this study was to compare the efficacy , safety , and cost of piperacillin/tazobactam with cefepime monotherapy in children with febrile neutropenia . A prospect i ve r and omized study in children and adolescent with cancer was conducted . Patients were r and omly assigned to receive either 80 mg/kg piperacillin/10 mg/kg tazobactam every 6 h ( maximum 4.5 g/dose ) or cefepime 50 mg/kg every 8 h ( maximum 2 g/dose ) . Treatment modification was defined as all the changes in the empirical antimicrobials after the first 96 h. Overall treatment success was defined as cure of febrile episode with or without modification . Cost of hospitalization , antimicrobial drugs , and supportive therapy were calculated . Fifty febrile netropenic episodes ( 25 in the piperacillin/tazobactam group , 25 in the cefepime group ) in 27 pediatric cancer patients were evaluated . The groups were comparable in terms of age , gender , body weight , primary diagnosis , disease status , initial neutrophil count , and duration of neutropenia . Microbiologically and clinical ly documented infection rate was 46 % . There was no infection-related mortality in the study period . The treatment success of initial empirical therapy without modification was not different in the 2 groups ( 56 % in piperacillin/tazobactam group and 48 % in cefepime group ) . Anti-anaerobic drugs were added more frequently in the cefepime group . Duration of fever , neutropenia , treatment , and cost of therapy were not different in the treatment groups .  Piperacillin/tazobactam monoterapy is as effective as cefepime monotherapy in febril neutropenia of pediatric cancer patients The efficacy , safety , and cost of cefepime and ceftazidime + amikacin as empirical therapy in children with febrile neutropenia is compared . A prospect i ve r and omized study in children with cancer was conducted . Patients were r and omly assigned to receive either cefepime 150 mg/kg/day or ceftazidime 150 mg/kg/day combined with amikacin 15 mg/kg/day . Treatment modification was defined as all the changes in the empirical antimicrobials after the first 72 h. Overall treatment success was defined as cure of febrile episode with or without modification . Costs of hospitalization , antimicrobial drugs , and supportive therapy were calculated . Fifty febrile netropenic episodes were evaluated . Infectious agents were microbiologically identified in 28 % of episodes . The incidence of gram-negative and gram-positive isolates was equal . Overall treatment success was 100 % and success of initial empirical therapy without modification was 52 and 40 % in the cefepime and cefepime + amikacin groups , respectively . The response rate after glycopeptides were added to the regimen was 64 and 52 % in the cefepime and cefepime + amikacin arms , respectively .  Glycopeptide and antifungal drugs  were added more frequently in the ceftazidime + amikacin group . Duration of fever , hospitalization , and antimicrobial drug administration were longer in the ceftazidime + amikacin arm . The costs of the antimicrobial drugs , hospitalization , and total cost were lower in the cefepime arm . Cefepime monotherapy is as effective as ceftazidime + amikacin combination in febrile neutropenia of pediatric cancer patients and must be preferred due to shorter defervescence of fever , shorter hospitalization , and lower therapy cost BACKGROUND Cefepime has been used in clinical therapeutic trials for meningitis , serious infection and febrile neutropenia , comprising more than 800 pediatric patients . This agent has also been used in patients 12 years of age and older with uncomplicated and complicated urinary tract infections including py 
    Output:
    
This review , however , suggests that cefepime  therapy in pediatric patients is not associated with an increased risk of adverse outcomes