Guideline for Antibacterial Prophylaxis Administration in Pediatric Cancer and Hematopoietic Stem Cell Transplantation.

Lehrnbecher, Thomas; Fisher, Brian T; Phillips, Bob; Alexander, Sarah; Ammann, Roland; Beauchemin, Melissa; Carlesse, Fabianne; Castagnola, Elio; Davis, Bonnie L; Dupuis, L Lee; Egan, Grace; Groll, Andreas H; Haeusler, Gabrielle M; Santolaya, Maria; Steinbach, William J; van de Wetering, Marianne; Wolf, Joshua; Cabral, Sandra; Robinson, Paula D and Sung, Lillian (2020). Guideline for Antibacterial Prophylaxis Administration in Pediatric Cancer and Hematopoietic Stem Cell Transplantation. Clinical infectious diseases, 71(1), pp. 226-236. Oxford University Press 10.1093/cid/ciz1082

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INTRODUCTION Bacteremia and other invasive bacterial infections are common among children with cancer receiving intensive chemotherapy and in pediatric recipients of hematopoietic stem cell transplantation (HSCT). Systemic antibacterial prophylaxis is one approach that can be used to reduce the risk of these infections. Our purpose was to develop a clinical practice guideline (CPG) for systemic antibacterial prophylaxis administration in pediatric cancer and HSCT patients. METHODS An international and multi-disciplinary panel was convened with representation from pediatric hematology/oncology and HSCT, pediatric infectious diseases (including antibiotic stewardship), nursing, pharmacy, a patient advocate and a CPG methodologist. The panel used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to generate recommendations based on the results of a systematic review of the literature. RESULTS The systematic review identified 114 eligible randomized trials of antibiotic prophylaxis. The panel made a weak recommendation for systemic antibacterial prophylaxis for children receiving intensive chemotherapy for acute myeloid leukemia and relapsed acute lymphoblastic leukemia (ALL). Weak recommendations against the routine use of systemic antibacterial prophylaxis were made for children undergoing induction chemotherapy for ALL, autologous HSCT and allogeneic HSCT. A strong recommendation against its routine use was made for children whose therapy is not expected to result in prolonged severe neutropenia. If used, prophylaxis with levofloxacin was recommended during severe neutropenia. CONCLUSIONS We present a CPG for systemic antibacterial prophylaxis administration in pediatric cancer and HSCT patients. Future research should evaluate the long-term effectiveness and adverse effects of prophylaxis.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Haematology/Oncology

UniBE Contributor:

Ammann, Roland

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1537-6591

Publisher:

Oxford University Press

Language:

English

Submitter:

Roland Ammann

Date Deposited:

24 Jan 2020 15:38

Last Modified:

26 Jun 2020 01:31

Publisher DOI:

10.1093/cid/ciz1082

PubMed ID:

31676904

Uncontrolled Keywords:

bacterial infection hematopoietic stem cell transplantation oncology pediatric practice guideline prevention

BORIS DOI:

10.7892/boris.137519

URI:

https://boris.unibe.ch/id/eprint/137519

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