Predictors of wait‐time for antibiotic initiation and association of wait‐time with hospital length of stay and ICU admission among children with cancer at the Southern Philippines Medical Center

Abstract

AWT is complex and multifactorial; it may be reduced by educating parents and care providers about infection and infection control and improving the availability of antibiotics and associated supplies. These interventions will most likely reduce ICU admissions and possibly LOS and increase the survival of pediatric oncology patients at SPMC.

The Golden Hour: Sustainability and Clinical Outcomes of Adequate Time to Antibiotic Administration in Children with Cancer and Febrile Neutropenia in Northwestern Mexico

“… 17 Similarly, a study in the Philippines reported that when assessing from fever onset to antibiotic administration, as much as 3.62 days elapsed, and the TTA was 15 hours. 16 Our baseline TTA was lower (75 minutes and 65 minutes, inpatient and ambulatory area, respectively) than the TTA reported in other studies. 12 , 13 , 16 , 17 This difference could be explained by the consultation area where care is provided and the TTA definition used.…”

“… 16 Our baseline TTA was lower (75 minutes and 65 minutes, inpatient and ambulatory area, respectively) than the TTA reported in other studies. 12 , 13 , 16 , 17 This difference could be explained by the consultation area where care is provided and the TTA definition used. Our patients are assessed directly in the inpatient and ambulatory areas and do not face delays in care in the ED, such as overcrowding or triage failure.…”

“…Barriers associated with TTA delays in pediatric cancer facilities in low- and middle-income countries include several factors that are usually absent in HICs. 16 The use of traditional medicine, lack of transportation, low level of caregiver's literacy, low socioeconomic status, and shortage of health care providers and antibiotics have been identified as potential areas to target when developing a TTA improvement strategy. 16 , 17 The most common barriers for prolonged TTA in HICs might not be common causes of delays in TTA in resource-constrained settings.…”

“… 16 The use of traditional medicine, lack of transportation, low level of caregiver's literacy, low socioeconomic status, and shortage of health care providers and antibiotics have been identified as potential areas to target when developing a TTA improvement strategy. 16 , 17 The most common barriers for prolonged TTA in HICs might not be common causes of delays in TTA in resource-constrained settings. For example, difficulties in obtaining central venous access because of inadequate topical analgesia are not issues for pediatric cancer facilities that do not have access to either central venous catheters or topical analgesia.…”

Challenges in managing infections among pediatric cancer patients: Suboptimal national essential medicines lists for low and middle income countries

“…For example, Gupta et al recently reported an infection‐related mortality proportion of 9.5% (52 infection‐related deaths/547 patients) among pediatric acute leukemia patients in El Salvador. In addition to delayed treatment for infections , inappropriate or ineffective antimicrobials are often used to treat infections in resource‐limited settings , which inevitably contributes to morbidity and mortality. A viable solution to addressing the use of inappropriate or ineffective antimicrobials may be to reallocate existing resources to the procurement and maintenance of appropriate and cost‐effective antimicrobials.…”