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, Ammann, Roland |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0941-4355 |
Publisher: |
Springer-Verlag |
Language: |
English |
Submitter: |
Anette van Dorland |
Date Deposited: |
24 Jan 2020 15:44 |
Last Modified: |
05 Dec 2022 15:34 |
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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