The Effect of the Neutropenic Diet in the Outpatient Setting: A Pilot Study

DeMille, Debra; Deming, Priscilla; Lupinacci, Paul; Jacobs, Linda A.

doi:10.1188/onf.06.337-343

Cited by 57 publications

(38 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…19 Thus, the available data do not support the use of a special low-bacteria diet in neutropenic patients. 20 Despite the lack of evidence, surveys showed that 43-78% of the hospitals use a special neutropenic diet.…”

Section: Prevention Of Infections By General Medical Management Of Aamentioning

confidence: 93%

Supportive care in severe and very severe aplastic anemia

Höchsmann

Moicean

Risitano

et al. 2012

Bone Marrow Transplant

View full text Add to dashboard Cite

for the EBMT Working Party on Aplastic AnemiaOptimal management of aplastic anemia (AA) is not confined to immediate diagnosis, early decision making and timely initiation of major treatment strategies (immunosuppression or SCT) but also involves supportive treatment as a crucial part of patient care. Patients are threatened by complications of cytopenia. Here, we summarize current recommendations for prevention and early treatment of fungal, bacterial and viral infections, transfusion strategy and iron chelation and assess the evidence basis. In fact, many recommendations for patients with AA are not based on randomized studies in AA itself, but they are deduced from other conditions with similar severity of cytopenia. Prevention and treatment of complications like hemorrhage, bacterial and fungal infections and of secondary events like alloimmunization to blood products and iron overload have a significant impact on the prognosis of AA patients and need to be carefully observed in daily practice. More controlled studies on supportive care should be performed in this rare disease.Bone Marrow Transplantation (2013) 48, 168-173; doi:10.1038/bmt.2012.220; published online 3 December 2012Keywords: aplastic anemia; supportive treatment; infection; transfusion; hematopoietic growth factors INTRODUCTION Survival of patients with aplastic anemia (AA) after both immunosuppression and allogeneic BMT improved substantially over the past 30 years. 1 For patients who received immunosuppression, this improvement was not restricted to patients who responded to the specific treatment. 2 Remarkably, the prognosis of non-responders to initial immunosuppression also improved substantially over time. 2 This is most likely due to the impact of supportive treatment on the overall survival of patients. The individual risk of a patient is mainly determined by the neutrophil, and monocyte counts. 2-8 During the past two decades, infection-related mortality and invasive fungal infections decreased. 2 However, infections are still the major threat for patients with severe or very severe AA. In the most recently published large clinical trials in AA, the most prevalent complications and the major causes of death still were bacterial and fungal infections. [3][4][5] In the following sections, we will summarize recommendations on the major aspects of supportive treatment in AA, that is, prophylaxis and early treatment of infections, transfusion strategy and treatment of iron overload.

show abstract

Section: Prevention Of Infections By General Medical Management Of Aamentioning

confidence: 93%

Supportive care in severe and very severe aplastic anemia

Höchsmann

Moicean

Risitano

et al. 2012

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…Patients receiving chemotherapy undergo many stressors including body image changes and an uncertain future [8]. Many patients identify appetite and weight as variables within their control, and food is seen as a nurturing and comforting area of life [8].…”

Section: Resultsmentioning

confidence: 99%

“…DeMille et al [8] sought to determine whether the use of the neutropenic diet (no fresh fruits and vegetables) in an outpatient setting influenced the number of febrile admissions and positive blood cultures. Twenty-three patients aged 33-67 years completed a 12-week program in which they were instructed on the neutropenic diet prior to chemotherapy.…”

Section: Published Studies On the Neutropenic Diet And Incidence Of Imentioning

confidence: 99%

“…The neutropenic diet is also called a sterile diet, low microbial diet, or a low bacterial diet (LBD). However, a standardized definition of the neutropenic diet has not been established [8,9]. Variations of the neutropenic diet include an exclusively sterile diet (e.g., all foods that have been made sterile by canning, baking, autoclaving, or irradiation), a LBD (well-cooked foods only), or a modified house diet (i.e., a regular diet omitting fresh fruits and vegetables) [8 -11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Benefit of the Neutropenic Diet: Fact or Fiction?

Jubelirer¹

2011

The Oncologist

View full text Add to dashboard Cite

There really should not be a debate about the use of neutropenic diet for cancer patients. Its usefulness has never been scientifically proven. However, neutropenic diets remain in place in many institutions even though their usefulness is controversial. Neutropenic diets were once thought to be important in protecting patients from having to succumb to infection from neutropenia while undergoing chemotherapy. Although food may contain harmful organisms and research has shown that bacterial translocation is possible, recent studies have been unable to obtain significant differences between placebo and intervention groups. The dietetic challenges neutropenic patients struggle with include decreased quality of life, malnutrition, gastrointestinal side effects, food aversion, and impaired cell-mediated immunity from vitamin deficiency. Unanswered questions in regard to the neutropenic diet include the following: (a) which food should be included; (b) which food preparation techniques improve patient compliance; (c) which patient populations benefit most; and (d) when should such a diet be initiated. Without scientific evidence, the best advice for neutropenic patients is to follow food safety guidelines as indicated by government entities. The Oncologist 2011;16:704 -707

show abstract

“…13 The latter trial corroborates the results of studies in adults. 14,15 However, most of the studies are weakened by a number of limitations such as insufficient sample size or the absence of documentation of other variables that affect the incidence of infectious complications.…”

Section: Discussionmentioning

confidence: 99%

Variations in non-pharmacological anti-infective measures in childhood leukemia - results of an international survey

et al. 2012

View full text Add to dashboard Cite

The online version of this article has a Supplementary Appendix. BackgroundStandardization in clinical practice may lead to improved outcomes. Unfortunately, little is known about the variability of non-pharmacological anti-infective measures in children with cancer. Design and MethodsA web-based survey assessed institutional recommendations regarding restrictions of social contacts, pets and food and instructions on wearing face masks in public for children with standard-risk acute lymphoblastic leukemia and acute myeloid leukemia during intensive chemotherapy. ResultsA total of 336 institutions in 27 countries responded to the survey (range, 1-76 institutions per country; overall response rate 61%). Most institutions recommend that patients with acute myeloid leukemia avoid indoor public places and daycare, kindergarten and school, whereas recommendations for patients with acute lymphoblastic leukemia differ considerably by institution. In terms of restrictions related to pets, there was a wide variability between institutions for both acute lymphoblastic and acute myeloid leukemia patients. Most, but not all institutions do not allow children with either acute lymphoblastic or acute myeloid leukemia to eat raw meat, raw seafood or unpasteurized milk. Whereas most institutions do not routinely recommend that patients with acute lymphoblastic leukemia wear face masks in public, advice on this matter varies for patients with acute myeloid leukemia. ConclusionsThe survey demonstrates that there is a wide variation in recommendations on non-pharmacological anti-infective measures between different institutions, countries and continents. This information may be used to encourage harmonization of supportive care practices and future clinical trials.

show abstract

The Effect of the Neutropenic Diet in the Outpatient Setting: A Pilot Study

Abstract: No clear evidence exists that the neutropenic diet makes a difference in overall rates of infection. Nursing research to compare the neutropenic diet with a less restrictive food safety education-focused diet is needed to guide clinical practice.

Cited by 57 publications

References 24 publications

Supportive care in severe and very severe aplastic anemia

Supportive care in severe and very severe aplastic anemia

The Benefit of the Neutropenic Diet: Fact or Fiction?

Variations in non-pharmacological anti-infective measures in childhood leukemia - results of an international survey

Contact Info

Product

Resources

About