A Prospective Multicenter SPOG 2003 FN Study of Microbiologically Defined Infections in Pediatric Cancer Patients with Fever and Neutropenia.
Data(s) |
10/03/2014
|
---|---|
Resumo |
BACKGROUND Fever and neutropenia (FN) often complicate anticancer treatment and can be caused by potentially fatal infections. Knowledge of pathogen distribution is paramount for optimal patient management. METHODS Microbiologically defined infections (MDI) in pediatric cancer patients presenting with FN by nonmyeloablative chemotherapy enrolled in a prospective multi-center study were analyzed. Effectiveness of empiric antibiotic therapy in FN episodes with bacteremia was assessed taking into consideration recently published treatment guidelines for pediatric patients with FN. RESULTS MDI were identified in a minority (22%) of pediatric cancer patients with FN. In patients with, compared to without MDI, fever (median, 5 [IQR 3-8] vs. 2 [IQR1-3] days, p < 0.001) and hospitalization (10 [6-14] vs. 5 [3-8] days, p < 0.001) lasted longer, transfer to the intensive care unit was more likely (13 of 95 [14%] vs. 7 of 346 [2.0%], p < 0.001), and antibiotics were given longer (10 [7-14] vs. 5 [4-7], p < 0.001). Empiric antibiotic therapy in FN episodes with bacteremia was highly effective if not only intrinsic and reported antimicrobial susceptibilities were considered but the purposeful omission of coverage for coagulase negative staphylococci and enterococci was also taken into account (81% [95%CI 68 - 90] vs. 96.6% [95%CI 87 - 99.4], p = 0.004) CONCLUSIONS: MDI were identified in a minority of FN episodes but they significantly affected management and the clinical course of pediatric cancer patients. Compliance with published guidelines was associated with effectiveness of empiric antibiotic therapy in FN episodes with bacteremia. |
Formato |
application/pdf application/pdf |
Identificador |
http://boris.unibe.ch/47800/1/00006454-900000000-98059.pdf http://boris.unibe.ch/47800/7/00006454-201409000-00007.pdf Agyeman, Philipp; Kontny, Udo; Nadal, David; Leibundgut, Kurt; Niggli, Felix; Simon, Arne; Kronenberg, Andreas; Frei, Reno; Escobar, Hugo; Kühne, Thomas; Beck-Popovic, Maja; Bodmer, Nicole; Ammann, Roland A. (2014). A Prospective Multicenter SPOG 2003 FN Study of Microbiologically Defined Infections in Pediatric Cancer Patients with Fever and Neutropenia. The Pediatric infectious disease journal, 33(9), e219-e225. Lippincott Williams & Wilkins 10.1097/INF.0000000000000326 <http://dx.doi.org/10.1097/INF.0000000000000326> doi:10.7892/boris.47800 info:doi:10.1097/INF.0000000000000326 info:pmid:24618935 urn:issn:1532-0987 |
Idioma(s) |
eng |
Publicador |
Lippincott Williams & Wilkins |
Relação |
http://boris.unibe.ch/47800/ |
Direitos |
info:eu-repo/semantics/openAccess info:eu-repo/semantics/openAccess |
Fonte |
Agyeman, Philipp; Kontny, Udo; Nadal, David; Leibundgut, Kurt; Niggli, Felix; Simon, Arne; Kronenberg, Andreas; Frei, Reno; Escobar, Hugo; Kühne, Thomas; Beck-Popovic, Maja; Bodmer, Nicole; Ammann, Roland A. (2014). A Prospective Multicenter SPOG 2003 FN Study of Microbiologically Defined Infections in Pediatric Cancer Patients with Fever and Neutropenia. The Pediatric infectious disease journal, 33(9), e219-e225. Lippincott Williams & Wilkins 10.1097/INF.0000000000000326 <http://dx.doi.org/10.1097/INF.0000000000000326> |
Palavras-Chave | #610 Medicine & health #570 Life sciences; biology |
Tipo |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion PeerReviewed |