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Keywords Guideline for Fever and Neutro...

Guideline for Fever and Neutropenia in Children With Cancer

https://read.qxmd.com/read/38291716/clinical-practice-guideline-inconsistent-management-of-fever-and-neutropenia-in-pediatric-oncology-a-children-s-oncology-group-study
#1
JOURNAL ARTICLE
L Lee Dupuis, Brian T Fisher, A J Sugalski, Allison Caren Grimes, Michelle Nuño, S Ramakrishnan, M P Beauchemin, Paula D Robinson, Nancy Santesso, Alexandra Walsh, A R Wrightson, Lolie Yu, Susan K Parsons, Lillian Sung
BACKGROUND: The primary objective was to measure the proportion of episodes where care delivery was inconsistent with selected recommendations of a clinical practice guideline (CPG) on fever and neutropenia (FN) management. The influence of site size on CPG-inconsistent care delivery, and association between patient outcomes and CPG-inconsistent care were described. METHODS: This retrospective, multicenter study included patients less than 21 years old with cancer who were at high risk of poor FN outcomes and were previously enrolled to a Children's Oncology Group (COG) study at participating National Cancer Institute Community Oncology Research Program (NCORP) institutions from January 2014 through December 2015...
January 30, 2024: Pediatric Blood & Cancer
https://read.qxmd.com/read/37918936/barriers-to-and-facilitators-of-effective-management-of-fever-episodes-in-hospitalised-kenyan-children-with-cancer-protocol-for-convergent-mixed-methods-study
#2
JOURNAL ARTICLE
Charles Nathaniel Nessle, Festus Njuguna, Julia Dettinger, Raphael Koima, Lenah Nyamusi, Evelynn Kisembe, Sarah Kinja, Mercy Ndung'u, Dennis Njenga, Sandra Langat, Gilbert Olbara, Cheryl Moyer, Terry Vik
INTRODUCTION: Febrile neutropenia is an oncological emergency in children with cancer, associated with serious infections and complications. In low-resourced settings, death from infections in children with cancer is 20 times higher than in high-resourced treatment settings, thought to be related to delays in antibiotic administration and management. The barriers to effective management of fever episodes in children with cancer have not previously been described. This convergent mixed-methods study will provide the evidence to develop fever treatment guidelines and to inform their effective implementation in children with cancer at Moi Teaching and Referral Hospital (MTRH), a level 6 referral hospital in western Kenya...
November 2, 2023: BMJ Open
https://read.qxmd.com/read/37746769/fluoroquinolone-prophylaxis-in-patients-with-neutropenia-at-high-risk-of-serious-infections-exploring-pros-and-cons
#3
REVIEW
Nikhil Singh, Karin Thursky, Gabriela Maron, Joshua Wolf
BACKGROUND: The use of fluoroquinolones to prevent infections in neutropenic patients with cancer or undergoing hematopoietic stem cell transplantation (HSCT) is a controversial issue, with international guidelines providing conflicting recommendations. Although potential benefits are clear, concerns revolve around efficacy, potential harms, and antimicrobial resistance (AMR) implications. DISCUSSION: Fluoroquinolone prophylaxis reduces neutropenic fever (NF) bloodstream infections and other serious bacterial infections, based on evidence from systematic reviews, randomized controlled trials, and observational studies in adults and children...
September 25, 2023: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://read.qxmd.com/read/36494902/does-age-play-a-role-in-fever-and-neutropenia-events-and-complications-a-comparison-of-adolescents-versus-younger-children-with-cancer-at-a-tertiary-care-pediatric-hospital-a-pilot-project
#4
JOURNAL ARTICLE
Nardin Kirolos, Ken Tang, Lesleigh S Abbott
BACKGROUND: Adolescents and young adults with cancer (AYA) are a complex group of patients. The development of fever and neutropenia (FN) is a potentially lethal complication of chemotherapy. Risk stratification of patients with FN has become increasingly valuable allowing for early intervention and to guide treatment type and duration appropriately. There are risk stratification guidelines that exist, but most are validated in young children with cancer (YCWC). AYA are frequently shown to have more numerous and severe side effects from chemotherapy...
December 9, 2022: Cancer reports
https://read.qxmd.com/read/36229765/the-dutch-working-party-on-antibiotic-policy-swab-recommendations-for-the-diagnosis-and-management-of-febrile-neutropenia-in-patients-with-cancer
#5
JOURNAL ARTICLE
J R de la Court, A H W Bruns, A H E Roukens, I O Baas, K van Steeg, M L Toren-Wielema, M Tersmette, N M A Blijlevens, R A G Huis In 't Veld, T F W Wolfs, W J E Tissing, Y Kyuchukova, J Heijmans
INTRODUCTION: This guideline was written by a multidisciplinary committee with mandated members of the Dutch Society for Infectious Diseases, Dutch Society for Hematology, Dutch Society for Medical Oncology, Dutch Association of Hospital Pharmacists, Dutch Society for Medical Microbiology, and Dutch Society for Pediatrics. The guideline is written for adults and pediatric patients. METHOD: The recommendations are based on the answers to nine questions formulated by the guideline committee...
December 2022: Infectious Diseases and Therapy
https://read.qxmd.com/read/36031722/non-neutropenic-fever-in-children-with-cancer-management-outcomes-and-clinical-decision-rule-validation
#6
JOURNAL ARTICLE
Hannah Walker, Adam J Esbenshade, Stephanie Dale, Kanika Bhatia, Zhiguo Zhao, Franz E Babl, Rachel Conyers, Gabrielle M Haeusler
INTRODUCTION: Fever and infection are an important complication of childhood cancer therapy. Most research and guideline development has focussed on febrile neutropenia, with a paucity directed at non-neutropenic fever (NNF). We describe the clinical presentation, management and outcomes of NNF in children with cancer, and externally validate the Esbenshade Vanderbilt (EsVan) clinical decision rules (CDR) to predict bacteraemia. METHOD: Using a prospective database, retrospective data were collected on consecutive NNF episodes (fever ≥38...
December 2022: Pediatric Blood & Cancer
https://read.qxmd.com/read/35884154/infections-during-non-neutropenic-episodes-in-pediatric-cancer-patients-results-from-a-prospective-study-in-two-major-large-european-cancer-centers
#7
JOURNAL ARTICLE
Stefan Schöning, Anke Barnbrock, Konrad Bochennek, Kathrin Gordon, Andreas H Groll, Thomas Lehrnbecher
Whereas the clinical approach in pediatric cancer patients with febrile neutropenia is well established, data on non-neutropenic infectious episodes are limited. We therefore prospectively collected over a period of 4 years of data on all infectious complications in children treated for acute lymphoblastic or myeloid leukemia (ALL or AML) and non-Hodgkin lymphoma (NHL) at two major pediatric cancer centers. Infections were categorized as fever of unknown origin (FUO), and microbiologically or clinically documented infections...
July 5, 2022: Antibiotics
https://read.qxmd.com/read/34879488/emergency-management-of-fever-and-neutropenia-in-children-with-cancer-a-review
#8
REVIEW
Christian D Pulcini, Skyler Lentz, Richard A Saladino, Richard Bounds, Ramsey Herrington, Marian G Michaels, Scott H Maurer
INTRODUCTION: Care of pediatric cancer patients is increasingly being provided by physicians in community settings, including general emergency departments. Guidelines based on current evidence have standardized the care of children undergoing chemotherapy or hematopoietic stem cell transplantation (HSCT) presenting with fever and neutropenia (FN). OBJECTIVE: This narrative review evaluates the management of pediatric patients with cancer and neutropenic fever and provides comparison with the care of the adult with neutropenic fever in the emergency department...
December 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/34871572/decision-tree-derivation-and-external-validation-of-a-new-clinical-decision-rule-discern-fn-to-predict-the-risk-of-severe-infection-during-febrile-neutropenia-in-children-treated-for-cancer
#9
JOURNAL ARTICLE
Mathilde Delebarre, Fanny Gonzales, Hélène Behal, Aude Tiphaine, Hélène Sudour-Bonnange, Anne Lutun, Samuel Abbou, Sophie Pertuisel, Sandrine Thouvenin-Doulet, Isabelle Pellier, Ludovic Mansuy, Christophe Piguet, Catherine Paillard, Laurence Blanc, Estelle Thebaud, Dominique Plantaz, Pascale Blouin, Pascale Schneider, Cécile Guillaumat, Pauline Simon, Carine Domenech, Hélène Pacquement, Marion Le Meignen, Claire Pluchart, Cécile Vérite, Geneviève Plat, Alain Martinot, Alain Duhamel, François Dubos
BACKGROUND: In 2017, international guidelines proposed new management of febrile neutropenia in children with cancer, adapted to the risk of severe infection by clinical decision rules (CDRs). Until now, none of the proposed CDRs has performed well enough in high-income countries for use in clinical practice. Our study aimed to build and validate a new CDR (DISCERN-FN) to predict the risk of severe infection in children with febrile neutropenia. METHODS: We did two prospective studies...
April 2022: Lancet Child & Adolescent Health
https://read.qxmd.com/read/34189607/survey-of-practices-for-the-clinical-management-of-febrile-neutropenia-in-children-in-hematology-oncology-units-in-latin-america
#10
JOURNAL ARTICLE
Mario A Melgar, Maysam R Homsi, Brooke Happ, Yin Su, Li Tang, Miriam L Gonzalez, Miguela A Caniza
The management of febrile neutropenia (FN) in pediatrics is evolving. Our objective was to describe current practices for the care of patients with FN in pediatric oncology centers in Latin America and identify areas for practice improvement. We used an online survey to enroll eligible healthcare providers who treat children with cancer in Latin America. The survey addressed respondents' characteristics, the environment of care, and FN care practices, including risk assessment, criteria for hospitalization, initial management of FN, evaluation, antibiotic administration, and discharge...
December 2021: Supportive Care in Cancer
https://read.qxmd.com/read/34133386/febrile-neutropenia-syndromes-in-children-risk-factors-and-outcomes-of-primary-prolonged-and-recurrent-fever
#11
JOURNAL ARTICLE
Muayad Alali, Michael Z David, Sandra A Ham, Lara Danziger-Isakov, Jennifer Pisano
BACKGROUND: The approach to recurrent febrile neutropenia (FN) in children with cancer has not been sufficiently addressed and was cited as a research gap in the International Pediatric Fever and Neutropenia (IPFNP) Guideline 2017. METHODS: Retrospective medical record review for all pediatric cancer patients with a diagnosis of FN was performed. Variables were collected at 2 different time sets (at day 1 and day 4 of presentation). Three FN syndromes have been defined based on the duration and time course of the fever: (1) primary: fever resolved before 96 hours and did not follow with recurrent fever; (2) prolonged fever: episodes failing to defervesce after at least 96 hours of antibacterial therapy; (3) recurrent fever: a new episode of fever >72 hours after resolution of the initial fever when a patient remained neutropenic and on antibiotics or if a fever developed within 1 week after antibiotic discontinuation...
October 1, 2021: Journal of Pediatric Hematology/oncology
https://read.qxmd.com/read/33616449/improving-antibiotic-timing-in-febrile-neutropenia-for-pediatric-oncology-patients-with-a-central-line
#12
JOURNAL ARTICLE
Jenae Roseland
Background: Febrile neutropenia in pediatric oncology patients is considered a medical emergency. This population is at risk for infection-related complications due to their immunocompromised state. The purpose of this evidence-based quality improvement project was to reduce the time in minutes from admission to antibiotic administration to within 60 min in at least 90% of pediatric oncology patients with a central line presenting with febrile neutropenia. Methods: An order set titled "FAST BREAK-Fever Neutropenia Admission" was created to expedite care during the first hour of admission, including labs, blood cultures, and a one-time STAT dose of intravenous cefepime...
May 2021: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://read.qxmd.com/read/32524514/management-of-children-with-fever-and-neutropenia-results-of-a-survey-in-51-pediatric-cancer-centers-in-germany-austria-and-switzerland
#13
JOURNAL ARTICLE
Max Scheler, Thomas Lehrnbecher, Andreas H Groll, Ruth Volland, Hans-Jürgen Laws, Roland A Ammann, Philipp Agyeman, Andishe Attarbaschi, Margaux Lux, Arne Simon
PURPOSE: Investigation of the current practice of diagnostics and treatment in pediatric cancer patients with febrile neutropenia. METHODS: On behalf of the German Society for Pediatric Oncology and Hematology and the German Society for Pediatric Infectious Diseases, an Internet-based survey was conducted in 2016 concerning the management of febrile neutropenia in pediatric oncology centers (POC). This survey accompanied the release of the corresponding German guideline to document current practice before its implementation in clinical practice...
August 2020: Infection
https://read.qxmd.com/read/30948447/neutropenic-diets-to-prevent-cancer-infections-updated-systematic-review-and-meta-analysis
#14
JOURNAL ARTICLE
Mohamad Bassam Sonbol, Tania Jain, Belal Firwana, Talal Hilal, Thomas Deleon, Angela Murad, M Hassan Murad, Nandita Khera
INTRODUCTION: Multiple studies have questioned the benefit of neutropenic diets in decreasing infections in patients with cancer, but recent surveys showed that such diets are still prescribed. In this study, we sought to evaluate the effectiveness of neutropenic diet in decreasing infection and mortality in neutropenic patients with cancer with neutropenia. This review is an update of a previously published systematic review. MATERIALS AND METHODS: We searched different databases to identify comparative studies that investigated the effect of neutropenic diet compared with regular diet in neutropenic adults and children with cancer...
December 2019: BMJ Supportive & Palliative Care
https://read.qxmd.com/read/30605229/early-discontinuation-of-antibiotics-for-febrile-neutropenia-versus-continuation-until-neutropenia-resolution-in-people-with-cancer
#15
JOURNAL ARTICLE
Anat Stern, Elena Carrara, Roni Bitterman, Dafna Yahav, Leonard Leibovici, Mical Paul
BACKGROUND: People with cancer with febrile neutropenia are at risk of severe infections and mortality and are thus treated empirically with broad-spectrum antibiotic therapy. However, the recommended duration of antibiotic therapy differs across guidelines. OBJECTIVES: To assess the safety of protocol-guided discontinuation of antibiotics regardless of neutrophil count, compared to continuation of antibiotics until neutropenia resolution in people with cancer with fever and neutropenia, in terms of mortality and morbidity...
January 3, 2019: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/30461508/treatment-of-fever-in-neutropenia-in-pediatric-oncology-patients
#16
REVIEW
Thomas Lehrnbecher
PURPOSE OF REVIEW: Fever during neutropenia is a common occurrence in children with cancer. A number of studies have recently been performed to refine algorithms regarding initiation, modification, and termination of antimicrobial treatment and are the basis for international pediatric-specific guidelines for the treatment of fever and neutropenia in children with cancer. RECENT FINDINGS: Although hospitalization and prompt initiation of intravenous broad-spectrum antibiotics remains the mainstay in the treatment of febrile neutropenic children with cancer, recent research has addressed a number of questions to optimize the management of these patients...
February 2019: Current Opinion in Pediatrics
https://read.qxmd.com/read/29589346/-recommendations-for-diagnostics-and-therapy-of-children-with-cancer-presenting-with-fever-and-neutropenia-comparison-of-two-current-guidelines
#17
REVIEW
Thomas Lehrnbecher, Andreas Groll, Philipp Agyeman, Roland A Ammann, Andishe Attarbaschi, Uta Behrends, Christoph Berger, Axel Hamprecht, Markus Hufnagel, Hans-Jürgen Laws, Max Scheler, Christian Temme, Simon Vieth, Arne Simon
Immunocompromised children and adolescents receiving treatment for cancer have a considerably increased risk for infection. Neutropenia is the most important single risk factor for infectious complications, and fever in neutropenia is considered as an emergency. Whereas guidelines for the management of fever in neutropenic adults have been established for decades, specific pediatric guidelines have not been developed until recently. As children differ in many aspects from adults such as in the underlying malignancy or in the availability and dosing of antimicrobial compounds, guidelines for pediatric patients are important...
April 2018: Klinische Pädiatrie
https://read.qxmd.com/read/28696047/a-randomized-trial-of-the-effectiveness-of-the-neutropenic-diet-versus-food-safety-guidelines-on-infection-rate-in-pediatric-oncology-patients
#18
RANDOMIZED CONTROLLED TRIAL
Karen M Moody, Rebecca A Baker, Ruth O Santizo, Inan Olmez, Jeanie M Spies, Amanda Buthmann, Linda Granowetter, Robin Y Dulman, Kanyalakshmi Ayyanar, Jonathan B Gill, Aaron E Carroll
BACKGROUND: The neutropenic diet (ND) is prescribed to avoid introduction of bacteria into a host's gastrointestinal tract and reduce infection. Due to a lack of evidence to support the ND, there continues to be debate among pediatric oncologists regarding its usefulness. This prospective randomized controlled trial evaluated the difference in neutropenic infection rates in pediatric oncology patients randomized to Food and Drug Administration approved food safety guidelines (FSGs) versus the ND plus FSGs during one cycle of chemotherapy...
January 2018: Pediatric Blood & Cancer
https://read.qxmd.com/read/28459614/guideline-for-the-management-of-fever-and-neutropenia-in-children-with-cancer-and-hematopoietic-stem-cell-transplantation-recipients-2017-update
#19
REVIEW
Thomas Lehrnbecher, Paula Robinson, Brian Fisher, Sarah Alexander, Roland A Ammann, Melissa Beauchemin, Fabianne Carlesse, Andreas H Groll, Gabrielle M Haeusler, Maria Santolaya, William J Steinbach, Elio Castagnola, Bonnie L Davis, L Lee Dupuis, Aditya H Gaur, Wim J E Tissing, Theo Zaoutis, Robert Phillips, Lillian Sung
Purpose To update a clinical practice guideline (CPG) for the empirical management of fever and neutropenia (FN) in children with cancer and hematopoietic stem-cell transplantation recipients. Methods The International Pediatric Fever and Neutropenia Guideline Panel is a multidisciplinary and multinational group of experts in pediatric oncology and infectious diseases that includes a patient advocate. For questions of risk stratification and evaluation, we updated systematic reviews of observational studies...
June 20, 2017: Journal of Clinical Oncology
https://read.qxmd.com/read/27107610/low-bacterial-diet-versus-control-diet-to-prevent-infection-in-cancer-patients-treated-with-chemotherapy-causing-episodes-of-neutropenia
#20
REVIEW
Elvira C van Dalen, Arno Mank, Edith Leclercq, Renée L Mulder, Michelle Davies, Marie José Kersten, Marianne D van de Wetering
BACKGROUND: Neutropenia is a potentially serious side effect of chemotherapy and a major risk factor for infection, which can be life-threatening. It has been hypothesised that a low bacterial diet (LBD) can prevent infection and (infection-related) mortality in cancer patients receiving chemotherapy that causes episodes of neutropenia, but much remains unclear. This review is an update of a previously published Cochrane review. OBJECTIVES: The primary objective of this review was to determine the efficacy of an LBD versus a control diet in preventing infection and in decreasing (infection-related) mortality in adult and paediatric cancer patients receiving chemotherapy that causes episodes of neutropenia...
April 24, 2016: Cochrane Database of Systematic Reviews
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