T Lehrnbecher1, A Stanescu, J Kühl. 1. Dept of Pediatric Hematology and Oncology, Children's Hospital III, Johann Wolfgang Goethe University, Frankfurt, Germany. thomas_lehrnbecher.yahoo.com
Abstract
BACKGROUND: Since the optimal duration of antibiotic therapy in febrile neutropenic patients is not clear, we evaluated the safety and efficacy of short courses of intravenous antibiotic treatment in selected pediatric cancer patients admitted for fever and neutropenia. PATIENTS AND METHODS: We retrospectively analyzed the clinical course of children with chemotherapy-induced neutropenia and fever. All patients were treated with empirical intravenous antibiotics. In episodes of fever of unknown origin (FUO), treatment regimen allowed discontinuation of antibiotics and early hospital discharge regardless of absolute neutrophil count (ANC) or evidence of bone marrow recovery as long as patients were afebrile for at least 24 h and had been treated for a minimum of 72 h. RESULTS: 106 episodes of febrile neutropenia occurred in 56 patients. 84 episodes were classified as FUO and intravenous antibiotic therapy was discontinued regardless of ANC when patients met the criteria described above. No death or major complication occurred. None of the patients had to be rehospitalized for recurrent fever or infection. CONCLUSION: Discontinuation of intravenous antibiotics regardless of ANC or evidence of bone marrow recovery seems safe and effective in pediatric cancer patients with FUO when children are afebrile for at least 24 h and are treated for a minimum of 72 h.
BACKGROUND: Since the optimal duration of antibiotic therapy in febrile neutropenicpatients is not clear, we evaluated the safety and efficacy of short courses of intravenous antibiotic treatment in selected pediatric cancerpatients admitted for fever and neutropenia. PATIENTS AND METHODS: We retrospectively analyzed the clinical course of children with chemotherapy-induced neutropenia and fever. All patients were treated with empirical intravenous antibiotics. In episodes of fever of unknown origin (FUO), treatment regimen allowed discontinuation of antibiotics and early hospital discharge regardless of absolute neutrophil count (ANC) or evidence of bone marrow recovery as long as patients were afebrile for at least 24 h and had been treated for a minimum of 72 h. RESULTS: 106 episodes of febrile neutropenia occurred in 56 patients. 84 episodes were classified as FUO and intravenous antibiotic therapy was discontinued regardless of ANC when patients met the criteria described above. No death or major complication occurred. None of the patients had to be rehospitalized for recurrent fever or infection. CONCLUSION: Discontinuation of intravenous antibiotics regardless of ANC or evidence of bone marrow recovery seems safe and effective in pediatric cancerpatients with FUO when children are afebrile for at least 24 h and are treated for a minimum of 72 h.
Authors: Youssef A Al-Tonbary; Othman E Soliman; Mohammed M Sarhan; Moustafa A Hegazi; Rasha A El-Ashry; Ashraf A El-Sharkawy; Osama S Salama; Raida Yahya Journal: World J Pediatr Date: 2010-06-12 Impact factor: 2.764
Authors: Diana Averbuch; Christina Orasch; Catherine Cordonnier; David M Livermore; Malgorzata Mikulska; Claudio Viscoli; Inge C Gyssens; Winfried V Kern; Galina Klyasova; Oscar Marchetti; Dan Engelhard; Murat Akova Journal: Haematologica Date: 2013-12 Impact factor: 9.941
Authors: Diana Averbuch; Catherine Cordonnier; David M Livermore; Malgorzata Mikulska; Christina Orasch; Claudio Viscoli; Inge C Gyssens; Winfried V Kern; Galina Klyasova; Oscar Marchetti; Dan Engelhard; Murat Akova Journal: Haematologica Date: 2013-12 Impact factor: 9.941