Management of fever and neutropenia in paediatric cancer patients: room for improvement?

Haeusler, Gabrielle M; Sung, Lillian; Ammann, Roland; Phillips, Bob (2015). Management of fever and neutropenia in paediatric cancer patients: room for improvement? Current opinion in infectious diseases, 28(6), pp. 532-538. Wolters Kluwer Lippincott Williams & Wilkins 10.1097/QCO.0000000000000208

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PURPOSE OF REVIEW Fever and neutropenia is the most common complication in the treatment of childhood cancer. This review will summarize recent publications that focus on improving the management of this condition as well as those that seek to optimize translational research efforts. RECENT FINDINGS A number of clinical decision rules are available to assist in the identification of low-risk fever and neutropenia however few have undergone external validation and formal impact analysis. Emerging evidence suggests acute fever and neutropenia management strategies should include time to antibiotic recommendations, and quality improvement initiatives have focused on eliminating barriers to early antibiotic administration. Despite reported increases in antimicrobial resistance, few studies have focused on the prediction, prevention, and optimal treatment of these infections and the effect on risk stratification remains unknown. A consensus guideline for paediatric fever and neutropenia research is now available and may help reduce some of the heterogeneity between studies that have previously limited the translation of evidence into clinical practice. SUMMARY Risk stratification is recommended for children with cancer and fever and neutropenia. Further research is required to quantify the overall impact of this approach and to refine exactly which children will benefit from early antibiotic administration as well as modifications to empiric regimens to cover antibiotic-resistant organisms.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Ammann, Roland

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0951-7375

Publisher:

Wolters Kluwer Lippincott Williams & Wilkins

Language:

English

Submitter:

André Schaller

Date Deposited:

11 Apr 2016 16:15

Last Modified:

01 Jan 2017 02:30

Publisher DOI:

10.1097/QCO.0000000000000208

PubMed ID:

26381997

BORIS DOI:

10.7892/boris.79322

URI:

https://boris.unibe.ch/id/eprint/79322

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