Diagnosis and Management of Febrile Neutropenia in Pediatric Oncology Patients—A Systematic Review
Infectious diseases are associated with a high morbidity and mortality rate among pediatric cancer patients undergoing treatment or receiving a transplant. Neutropenia represents a potentially fatal complication of cancer treatment and is associated with a high risk of developing bacterial infection...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/8/1800 |
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| author | Estera Boeriu Alexandra Borda Dan Dumitru Vulcanescu Vlad Sarbu Smaranda Teodora Arghirescu Ovidiu Ciorica Felix Bratosin Iosif Marincu Florin George Horhat |
| author_facet | Estera Boeriu Alexandra Borda Dan Dumitru Vulcanescu Vlad Sarbu Smaranda Teodora Arghirescu Ovidiu Ciorica Felix Bratosin Iosif Marincu Florin George Horhat |
| author_sort | Estera Boeriu |
| collection | DOAJ |
| description | Infectious diseases are associated with a high morbidity and mortality rate among pediatric cancer patients undergoing treatment or receiving a transplant. Neutropenia represents a potentially fatal complication of cancer treatment and is associated with a high risk of developing bacterial infections. Although febrile neutropenia (FN) can affect both adults and children, the latter has a higher chance of infections with an unknown origin. Prompt empiric broad-spectrum antibiotic administration is collectively considered the best therapeutic approach. This review aims to analyze the latest works from the literature regarding the therapeutic strategies, schemes, and approaches and the efficacy of these in pediatric febrile neutropenia. Following PRISMA guidelines, an advanced search on PubMed, Scopus, and Cochrane Library, using the keywords “febrile neutropenia”, “pediatric”, “cancer”, and “oncology”, was performed. A total of 197 articles were found to be eligible. After screening the abstracts and excluding unfit studies, 16 articles were analyzed. There were eight retrospective studies, five prospective studies, and two clinical trials. Altogether, these studies have described around 5000 episodes of FN. The median age of the participants was 7.6 years, and the underlying condition for most of them was acute leukemia. The infectious agent could only be determined in around one-fifth of cases, from which 90% were of bacterial origin. As such, empirical broad-spectrum antibiotics are used, with the most used treatment scheme comprising third- and fourth-generation cephalosporins and antipseudomonal penicillins. In order to improve the treatment strategies of FN episodes and to successfully de-escalate treatments toward narrower-spectrum antibiotics, hospitals and clinics should increase their efforts in identifying the underlying cause of FN episodes through blood culture urine culture and viral tests, wherever infrastructure enables it. |
| first_indexed | 2024-03-09T13:36:14Z |
| format | Article |
| id | doaj.art-a24e147561624484957293821cf1dbf4 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T13:36:14Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-a24e147561624484957293821cf1dbf42023-11-30T21:12:21ZengMDPI AGDiagnostics2075-44182022-07-01128180010.3390/diagnostics12081800Diagnosis and Management of Febrile Neutropenia in Pediatric Oncology Patients—A Systematic ReviewEstera Boeriu0Alexandra Borda1Dan Dumitru Vulcanescu2Vlad Sarbu3Smaranda Teodora Arghirescu4Ovidiu Ciorica5Felix Bratosin6Iosif Marincu7Florin George Horhat8Department of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaDepartment of Oncology and Haematology, “Louis Turcanu” Emergency Clinical Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, RomaniaMultidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaMultidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaDepartment of Pediatrics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, RomaniaBusiness Administration and Economics Faculty, West University of Timisoara, Johann Heinrich Pestalozzi Street 16, 300115 Timisoara, RomaniaMethodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaMethodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaMultidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, RomaniaInfectious diseases are associated with a high morbidity and mortality rate among pediatric cancer patients undergoing treatment or receiving a transplant. Neutropenia represents a potentially fatal complication of cancer treatment and is associated with a high risk of developing bacterial infections. Although febrile neutropenia (FN) can affect both adults and children, the latter has a higher chance of infections with an unknown origin. Prompt empiric broad-spectrum antibiotic administration is collectively considered the best therapeutic approach. This review aims to analyze the latest works from the literature regarding the therapeutic strategies, schemes, and approaches and the efficacy of these in pediatric febrile neutropenia. Following PRISMA guidelines, an advanced search on PubMed, Scopus, and Cochrane Library, using the keywords “febrile neutropenia”, “pediatric”, “cancer”, and “oncology”, was performed. A total of 197 articles were found to be eligible. After screening the abstracts and excluding unfit studies, 16 articles were analyzed. There were eight retrospective studies, five prospective studies, and two clinical trials. Altogether, these studies have described around 5000 episodes of FN. The median age of the participants was 7.6 years, and the underlying condition for most of them was acute leukemia. The infectious agent could only be determined in around one-fifth of cases, from which 90% were of bacterial origin. As such, empirical broad-spectrum antibiotics are used, with the most used treatment scheme comprising third- and fourth-generation cephalosporins and antipseudomonal penicillins. In order to improve the treatment strategies of FN episodes and to successfully de-escalate treatments toward narrower-spectrum antibiotics, hospitals and clinics should increase their efforts in identifying the underlying cause of FN episodes through blood culture urine culture and viral tests, wherever infrastructure enables it.https://www.mdpi.com/2075-4418/12/8/1800febrile neutropeniapediatric oncologybroad-spectrum antibiotics |
| spellingShingle | Estera Boeriu Alexandra Borda Dan Dumitru Vulcanescu Vlad Sarbu Smaranda Teodora Arghirescu Ovidiu Ciorica Felix Bratosin Iosif Marincu Florin George Horhat Diagnosis and Management of Febrile Neutropenia in Pediatric Oncology Patients—A Systematic Review Diagnostics febrile neutropenia pediatric oncology broad-spectrum antibiotics |
| title | Diagnosis and Management of Febrile Neutropenia in Pediatric Oncology Patients—A Systematic Review |
| title_full | Diagnosis and Management of Febrile Neutropenia in Pediatric Oncology Patients—A Systematic Review |
| title_fullStr | Diagnosis and Management of Febrile Neutropenia in Pediatric Oncology Patients—A Systematic Review |
| title_full_unstemmed | Diagnosis and Management of Febrile Neutropenia in Pediatric Oncology Patients—A Systematic Review |
| title_short | Diagnosis and Management of Febrile Neutropenia in Pediatric Oncology Patients—A Systematic Review |
| title_sort | diagnosis and management of febrile neutropenia in pediatric oncology patients a systematic review |
| topic | febrile neutropenia pediatric oncology broad-spectrum antibiotics |
| url | https://www.mdpi.com/2075-4418/12/8/1800 |
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