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- Title
Outpatient and oral antibiotic management of low-risk febrile neutropenia are effective in children--a systematic review of prospective trials.
- Authors
Manji A; Beyene J; Dupuis LL; Phillips R; Lehrnbecher T; Sung L; Manji, A; Beyene, J; Dupuis, L L; Phillips, R; Lehrnbecher, T; Sung, L
- Abstract
<bold>Background: </bold>There is no consensus on whether therapeutic intensity can be reduced safely in children with low-risk febrile neutropenia (FN). Our primary objective was to determine whether there is a difference in efficacy between outpatient and inpatient management of children with low-risk FN. Our secondary objective was to compare oral and parenteral antibiotic therapy in this population.<bold>Methods: </bold>We performed electronic searches of Ovid Medline, EMBASE, and the Cochrane Central Register of Controlled Trials, and limited studies to prospective pediatric trials in low-risk FN. Percentages were used as the effect measure.<bold>Results: </bold>From 7,281 reviewed articles, 16 were included in the meta-analysis. Treatment failure, including antibiotic modification, was less likely to occur in the outpatient setting compared with the inpatient setting (15 % versus 28 %, P = 0.04) but was not significantly different between oral and parenteral antibiotic regimens (20 % versus 22 %, P = 0.68). Of the 953 episodes treated in the outpatient setting and 676 episodes treated with oral antibiotics, none were associated with infection-related mortality.<bold>Conclusion: </bold>Based on the combination of results from all prospective studies to date, outpatient and oral antibiotic management of low-risk FN are effective in children and should be incorporated into clinical care where feasible.
- Publication
Supportive Care in Cancer, 2012, Vol 20, Issue 6, p1135
- ISSN
0941-4355
- Publication type
journal article
- DOI
10.1007/s00520-012-1425-8