Interventions aiming to reduce time to antibiotics (TTA) in patients with fever and neutropenia during chemotherapy for cancer (FN), a systematic review.

Koenig, Christa; Schneider, Christine; Morgan, Jessica E.; Ammann, Roland A.; Sung, Lillian; Phillips, Bob (2020). Interventions aiming to reduce time to antibiotics (TTA) in patients with fever and neutropenia during chemotherapy for cancer (FN), a systematic review. Supportive care in cancer, 28(5), pp. 2369-2380. Springer-Verlag 10.1007/s00520-019-05056-w

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PURPOSE Multiple interventions have been developed aiming to reduce time to antibiotics (TTA) in patients with fever and neutropenia (FN) following chemotherapy for cancer. We evaluated their effect to reduce TTA and their impact on important clinical outcomes in a systematic review. METHODS The search covered seven databases. Biases and quality of studies were assessed with the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Interventions could be implemented in any setting and performed by any person included in the FN management. Absolute change of TTA was the primary outcome. Registration: PROSPERO (CRD42018092948). RESULTS Six thousand two hundred ninety-six titles and abstracts were screened, 177 studies were retrieved and 30 studies were included. Risk of bias was moderate to serious in 28 studies and low in two studies. All but one study reported a reduction of TTA after the intervention. Various types of interventions were implemented; they most commonly aimed at professionals. Most of the studies made more than one single intervention. CONCLUSION This review may help centers to identify their specific sources of delay and barriers to change and to define what intervention may be the best to apply. This review supports the assertion that TTA can be considered a measure of quality of care, emphasizes the importance of education and training, and describes the very different interventions which have effectively reduced TTA.

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

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

König, Christa; Schneider, Christine and Ammann, Roland

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0941-4355

Publisher:

Springer-Verlag

Language:

English

Submitter:

Roland Ammann

Date Deposited:

24 Jan 2020 15:44

Last Modified:

22 Mar 2020 01:33

Publisher DOI:

10.1007/s00520-019-05056-w

PubMed ID:

31486984

Uncontrolled Keywords:

Cancer Fever Neutropenia Oncology Quality improvement projects Systematic review Time to antibiotics

BORIS DOI:

10.7892/boris.137520

URI:

https://boris.unibe.ch/id/eprint/137520

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