Febrile Neutropenia in Children with Cancer: Approach to Diagnosis and Treatment

Kebudi, Rejin; Kizilocak, Hande

doi:10.2174/1573396314666180508121625

Cited by 43 publications

(41 citation statements)

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“…The possible reasons for this shift are better control Solid tumor cancer 6 1 2 Staphylococcus aureus (MRSA) has been noted. Gramnegative bacteremia may be relatively more frequent in lowincome settings due to the absence of central venous lines [17,18]. Similar suggestive results in studies conducted in paediatric neutropenic patients in Turkey by Celkan [19] and Sweden by Bjorkholm et al [20] reported that gram-positive organisms were more pre-dominant by 60-69%.…”

Section: Discussionmentioning

confidence: 61%

Assessment of Antimicrobial Prescription Pattern among Paediatric Cancer Patients with Febrile Neutropenia

Abraham

George

Sajith

et al. 2019

SN Compr. Clin. Med.

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Febrile neutropenia (FN) is the most common haematological toxicity associated with cytotoxic chemotherapy. Individual studies are available, but national estimates on FN are required. To describe chemotherapy-induced neutropenia, its associated infection-causing organisms, and the antimicrobials prescribed, a prospective cum retrospective study was conducted for a period of 9 months, which included 50 paediatric cancer patients less than 18 years. Patients having an absolute neutrophil count (ANC) less than 1500/mm 3 , having body temperature of above 38.5°C, and receiving anti-infectives as prophylaxis were included. Patient demographic details, presenting complaints, absolute neutrophil count, and laboratory findings were noted in a patient proforma. Out of the overall 584 episodes of CIN, 188 episodes (32.2%) were of febrile neutropenia. Majority of patients were boys (70%), aged between 1 and 6 years (66%), and diagnosed with acute lymphoblastic leukemia (64%). The mean ANC was 765.6 ± 235.7 × 10 9 /l. From a total of 188 episodes of FN, in 179 episodes, patients had ANC < 500 mm 3 , whereas in 9 episodes, patients had ANC < 100 mm 3. The predominant site of infection in these patients was bloodstream (27%), followed by urine (6%) and stool (1%). From the 51 episodes of blood culture done, the highest reported was of Staphylococcus species (49.01%). Anti-infective combinations of piperacillin/vancomycin (56%) and piperacillin/amikacin (42%) were given. Patients with positive fungal growth received Inj. amphotericin (18%) as therapy. Majority of the children undergoing chemotherapy, diagnosed with ALL, had FN. Low ANC led them susceptible to various bacterial and fungal infections. Introduction to antimicrobials and antifungals have all contributed to decreasing chemotherapy-related infections.

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Section: Discussionmentioning

confidence: 61%

Assessment of Antimicrobial Prescription Pattern among Paediatric Cancer Patients with Febrile Neutropenia

Abraham

George

Sajith

et al. 2019

SN Compr. Clin. Med.

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“…But comparative study at Bangabandhu Sheikh Mujib Medical University Hospital showed that empirical treatment of FN with combined cefepime and amikacin is more effective than combination of ceftriaxone and gentamicin in children with malignancies [14]. Empiric antibiotic therapy with agents active on viridans group Streptococci and Pseudomonas aeruginosa are recommended as a standard of care in high-risk FN childhood cancer patients to provide coverage for virulent organisms while minimizing exposure to unnecessary antibiotics, because indiscriminant use of broad-spectrum antibiotics may accelerate antibiotic resistance rates [3, 15]. β-Lactams and aminoglycosides were the most common antibiotics used in our setup.…”

Section: Discussionmentioning

confidence: 99%

Febrile neutropenia management in pediatric cancer patients at Ethiopian Tertiary Care Teaching Hospital

et al. 2019

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Objective This study aimed at assessing the management practice of febrile neutropenia (FN) in pediatric cancer patients at Tikur Anbessa Specialized Hospital (TASH), Ethiopia by reviewing patients’ charts from 135 participants retrospectively. Data was entered into Epi-info 7 and exported to SPSS 20 for analysis. Results Empiric antibiotics therapy (EAT) was given to all patients in which ceftriaxone with gentamycin constituted of 71.8% followed by ceftriaxone monotherapy. EATs were converted to others in 20 (14.8%) and 2 (1.5%) patients for the first and second times respectively, mainly based on poor clinical response without conducting culture and sensitivity tests. These tests were done only for 13 (9.6%) participants and growth was seen in 5 patients; and definitive therapy was given for 2 patients. ANC value was above 500 cell/mm 3 in 80.7% of patients and 98.5% of study participants were afebrile after completion FN treatment. Most of them (70.4%) were treated for FN and 7 of patients died due to all case mortality. The hospital should not rely mainly only on ceftriaxone with gentamycin as EAT and should do culture and sensitivity test to optimize therapy based on susceptibility result before conversion and modification of therapy in management of FN.

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“…Regarding to the EAT, combination of ceftriaxone and gentamycin constituted around 72% of the regimen in the current study. But comparative study at Bangabandhu Sheikh Mujib Medical University Hospital showed that empirical treatment of FN with combined cefepime and amikacin is more effective than combination of ceftriaxone and gentamicin in children with malignancies [14].Empiric antibiotic therapy with agents active on viridans group streptococci and pseudomonas aeruginosa are recommended as a standard of care in high-risk FN childhood cancer patients to provide coverage for virulent organisms while minimizing exposure to unnecessary antibiotics, because indiscriminant use of broad-spectrum antibiotics may accelerate antibiotic resistance rates [3,15]. β-lactams and aminoglycosides were the most common antibiotics used in our setup.…”

Section: Discussionmentioning

confidence: 99%

Febrile neutropenia management in pediatric cancer patients at Ethiopian Tertiary Care Teaching Hospital

Bedewi

Berihun

Mulu

et al. 2019

Preprint

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Objective This study aimed at assessing the management practice of febrile neutropenia (FN) in pediatric cancer patients at Tikur Anbessa Specialized Hospital (TASH), Ethiopia by reviewing patients’ charts from 135 participants retrospectively. Data was entered into Epi-info 7 and exported to SPSS 20 for analysis. Results Empiric antibiotics therapy (EAT) was given to all patients in which ceftriaxone with gentamycin constituted of 71.9% followed by ceftriaxone monotherapy. EATs were converted to others in 20 (14.8%) and 2(1.5%) patients for the first and second times respectively, mainly based on poor clinical response without conducting culture and sensitivity tests. These tests were done only for 13 (9.6%) participants and growth was seen in 5 patients; and definitive therapy was given for 2 patients. ANC value was above 500 cell/mm3 in 80.7% of patients and 98.5% of study participants were afebrile after completion FN treatment. Most of them (70.4%) were treated for FN and 7 of patients died due to all case mortality. The hospital should not rely mainly only on ceftriaxone with gentamycin as EAT and also should do culture and sensitivity test to optimize therapy based on susceptibility result before conversion and modification of therapy in management of FN.

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Febrile Neutropenia in Children with Cancer: Approach to Diagnosis and Treatment

Cited by 43 publications

References 0 publications

Assessment of Antimicrobial Prescription Pattern among Paediatric Cancer Patients with Febrile Neutropenia

Assessment of Antimicrobial Prescription Pattern among Paediatric Cancer Patients with Febrile Neutropenia

Febrile neutropenia management in pediatric cancer patients at Ethiopian Tertiary Care Teaching Hospital

Febrile neutropenia management in pediatric cancer patients at Ethiopian Tertiary Care Teaching Hospital

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