Time to First Dose of Antibiotics in Children with Cancer and Febrile Neutropenia. A Report from a Peruvian Hospital

Abstract

The Febrile Neutropenia (FN) in children with cancer may be the only indication of a serious underlying infection, which can lead to sepsis and be fatal; it is recommend start antibiotics as soon as possible. We realized a retrospective analysis of all patients under 14 years of age with cancer, who attended the Pediatric Emergency of Rebagliati Hospital (Lima-Peru), between July 2016 and February 2017, due to fever, neutropenia and history to received chemotherapy in the last 15 days. Of 36079 emergency attentions, 31 were episodes of FN. The median of time from arrival to emergency to the first dose of antibiotic or Time To Antibiotics (TTA) was 206 minutes (Interquartile range [IQR], 137-390). Patients with leukemia had a lower TTA than patients with solid tumors (p = 0.037). The TTA after 120 minutes was not associated with longer hospital stay, transfer to the PICU or mortality. In the cases evaluated, the TTA exceeded the international standards. Patients with solid tumors have higher TTA than patients with leukemia. It is necessary to create a multidisciplinary program to improve this time.