Adherence to the febrile neutropenia protocol in pediatric leukemia patients at a Brazilian Cancer Center-A retrospective audit.

IF 1.2 4区医学 Q4 HEMATOLOGY

Pediatric Hematology and Oncology Pub Date : 2025-07-01 DOI:10.1080/08880018.2025.2525267

Jessica Talita Mariana Wicthoff Raniero, Anita Cassoli Cortez, Cecilia Maria Lima da Costa, Luciana Mariano Palanch Piotto, Ivan Leonardo Avelino França E Silva, Viviane Sonaglio, Marjorie Vieira Batista

{"title":"Adherence to the febrile neutropenia protocol in pediatric leukemia patients at a Brazilian Cancer Center-A retrospective audit.","authors":"Jessica Talita Mariana Wicthoff Raniero, Anita Cassoli Cortez, Cecilia Maria Lima da Costa, Luciana Mariano Palanch Piotto, Ivan Leonardo Avelino França E Silva, Viviane Sonaglio, Marjorie Vieira Batista","doi":"10.1080/08880018.2025.2525267","DOIUrl":null,"url":null,"abstract":"Pediatric patients with hematologic cancers, especially those undergoing chemotherapy, are highly vulnerable to infections and febrile neutropenia (FN). Noncompliance with FN protocols often leads to excessive antibiotic use, raising the risk of multidrug-resistant bacteria and contributing to higher mortality rates. This retrospective study aimed to assess inappropriate empirical antibiotic treatment (IEAT) rates during FN episodes and identify risk factors for mortality among pediatric patients diagnosed with acute leukemia and FN at the A.C. Camargo Cancer Center between January 1, 2010, and December 31, 2020. A total of 329 FN episodes in 84 patients were analyzed, revealing an overall IEAT rate of 40%. The study identified key issues such as 2% of inadequate Gram-positive coverage, 78% of failure to de-escalate antibiotic treatment and 62% of maintenance antibiotic administration despite negative cultures Bloodstream infections were found in 77% of episodes, with age over 13 years (p 0.003), and bloodstream infection (p 0.002) being significant risk factors for mortality.","PeriodicalId":19746,"journal":{"name":"Pediatric Hematology and Oncology","volume":" ","pages":"1-11"},"PeriodicalIF":1.2000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Hematology and Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08880018.2025.2525267","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Pediatric patients with hematologic cancers, especially those undergoing chemotherapy, are highly vulnerable to infections and febrile neutropenia (FN). Noncompliance with FN protocols often leads to excessive antibiotic use, raising the risk of multidrug-resistant bacteria and contributing to higher mortality rates. This retrospective study aimed to assess inappropriate empirical antibiotic treatment (IEAT) rates during FN episodes and identify risk factors for mortality among pediatric patients diagnosed with acute leukemia and FN at the A.C. Camargo Cancer Center between January 1, 2010, and December 31, 2020. A total of 329 FN episodes in 84 patients were analyzed, revealing an overall IEAT rate of 40%. The study identified key issues such as 2% of inadequate Gram-positive coverage, 78% of failure to de-escalate antibiotic treatment and 62% of maintenance antibiotic administration despite negative cultures Bloodstream infections were found in 77% of episodes, with age over 13 years (p 0.003), and bloodstream infection (p 0.002) being significant risk factors for mortality.

查看原文本刊更多论文

巴西癌症中心儿童白血病患者发热性中性粒细胞减少方案的依从性-回顾性审计。

患有血液学癌症的儿童患者，特别是那些正在接受化疗的患者，极易受到感染和发热性中性粒细胞减少症（FN）的影响。不遵守FN方案往往导致过度使用抗生素，增加耐多药细菌的风险，并导致更高的死亡率。本回顾性研究旨在评估2010年1月1日至2020年12月31日在A.C. Camargo癌症中心诊断为急性白血病和FN的儿科患者中，FN发作期间不适当的经验抗生素治疗（IEAT）率，并确定死亡的危险因素。对84例患者的329次FN发作进行了分析，显示总体IEAT率为40%。该研究确定了关键问题，例如2%的革兰氏阳性覆盖不足，78%的抗生素治疗未能降级，62%的维持抗生素治疗尽管培养阴性，但在77%的发作中发现血流感染，年龄超过13岁（p 0.003），血流感染（p 0.002）是死亡率的重要危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Pediatric Hematology and Oncology 医学-小儿科

CiteScore

2.60

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： PHO: Pediatric Hematology and Oncology covers all aspects of research and patient management within the area of blood disorders and malignant diseases of childhood. Our goal is to make PHO: Pediatric Hematology and Oncology the premier journal for the international community of clinicians and scientists who together aim to define optimal therapeutic strategies for children and young adults with cancer and blood disorders. The journal supports articles that address research in diverse clinical settings, exceptional case studies/series that add novel insights into pathogenesis and/or clinical care, and reviews highlighting discoveries and challenges emerging from consortia and conferences. Clinical studies as well as basic and translational research reports regarding cancer pathogenesis, genetics, molecular diagnostics, pharmacology, stem cells, molecular targeting, cellular and immune therapies and transplantation are of interest. Papers with a focus on supportive care, late effects and on related ethical, legal, psychological, social, cultural, or historical aspects of these fields are also appreciated. Reviews on important developments in the field are welcome. Articles from scientists and clinicians across the international community of Pediatric Hematology and Oncology are considered for publication. The journal is not dependent on or connected with any organization or society. All submissions undergo rigorous peer review prior to publication. Our Editorial Board includes experts in Pediatric Hematology and Oncology representing a wide range of academic and geographic diversity.