Fever and neutropenia hospital discharges in children with cancer: A 2012 update

Healthcare utilization and spending by children with cancer on Medicaid

“…There is a wide range of reasons children with cancer require inpatient hospital care including the administration of chemotherapy and the management of cancer‐related or therapy‐induced complications such as FN. FN is a common reason for admission among children with cancer, but there is evidence to suggest that we could reduce or shorten the length of inpatient stays for low‐risk patients . It is imperative to take the financial impact of outpatient therapy for FN into account, especially for those patients and families with limited resources (including financial and travel).…”

“…Children with cancer represent a unique patient population with high resource, complex healthcare needs . Prior to diagnosis, these children may interact minimally with the healthcare system; upon diagnosis, their needs dramatically change.…”

“…Children with cancer represent a unique patient population with high resource, complex healthcare needs. [1][2][3][4][5] Prior to diagnosis, these children may interact minimally with the healthcare system; upon diagnosis, their needs dramatically change. However, little research has been devoted to understanding healthcare utilization in this population.…”

Changing Microbiological Pattern of Pediatric Febrile Neutropenia

“…A recent systematic review of randomized control trials in pediatric FN [37] concluded that antipseudomonal penicillin and fourth-generation cephalosporin monotherapy were associated with similar failure and mortality rates as aminoglycoside containing combination therapy. The current recommendations also advise monotherapy as initial empirical antibiotic therapy in pediatric FN [3][4][5][6][7][8][9]. Further, Outpatient management and oral antibiotics were found to be safe in low-risk FN with no infection-related mortality observed in any patient and no significant differences in outcomes compared with inpatient management and intravenous therapy.…”

“…The host vulnerability to infection and related complications depends on the patients' underlying disease and the chemotherapy they receive [5]. Indeed an audit of all hospital admission for pediatric FN during the year 2012 in US [8] revealed that 39% of the discharges had a short length of stay (SLOS) of ≤ 3 days; viral infection and upper respiratory infection comprising the majority with 66.4% of them had no identifiable infections. This has led to the risk based approach and use of intravenous or oral antibiotics in 'low risk' patients [9].…”