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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
120
Ceftazidime 150 mg/kgBW/24 hours divided into 3 doses.
Ciprofloxacin 10 mg/kgBW/12 hours
RSUP dr Sardjito
Sleman, DI Yogyakarta, Indonesia
RECRUITINGDuration of fever
Duration of fever since receiving the first antibiotic, based on the temperature graph available in the electronic medical record
Time frame: from first administration of Ciprofloxacin or Ceftazidime to 48 hours fever free
Duration of Neutropenia
The length of time the subject experiences neutropenia, absolute neutrophil count is \<500
Time frame: From first antibiotic administration to 48 hours after administration
Duration of hospitalization
The duration from the date of subject recruitment to the date of hospital discharge, as recorded in the electronic medical record.
Time frame: From first administration of Ciprofloxacin or Ceftazidime to hospital discharge
Duration of antibiotic use
days of antibiotic use from the first administration to the last intravenous antibiotic administration
Time frame: days from first administration to the last intravenous antibiotic administration
Antibiotic escalation decisions
Clinician decisions in escalating empirical antibiotics to second-line antibiotics
Time frame: From first administration of Ciprofloxacin or Ceftazidime to 48 hours after administration
Mortality
Mortality of subject in admission is proven by a death certificate
Time frame: from first administration of ciprofloxacin or ceftazidime to 30 days after recruitment
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.