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BMC Pediatrics

, 5:10

First Online: 18 May 2005Received: 14 December 2004Accepted: 18 May 2005

Abstract

BackgroundThere are no standard criteria for when to discontinue intravenous antimicrobial therapy IVAMT in children with febrile neutropenia FN, but it is now common to discontinue IVAMT and discharge patients with an absolute neutrophil count ANC ≤ 500 -mm. The purpose of this study was to evaluate the outcome of a large cohort of children with FN who had IVAMT discontinued with an ANC ≤ 500 -mm

MethodsA retrospective chart review was completed of patients in the Northern Alberta Children-s Cancer Program with FN and no apparent clinical source of fever from June 1, 1997 to July 1, 2002.

ResultsOut of a total of 275 patients, 127 46% had at least one episode of FN, with FN occurring in patients with sarcomas more commonly than in those with leukemia- lymphoma and least in those with other solid tumors. In 59 of 276 episodes of FN 21% patients had a microbiologically defined infection at admission. Of the 217 remaining episodes, 112 of 199 patients 56% with known neutrophil counts had IVAMT discontinued before their absolute neutrophil count ANC reached 500 -mm at the discretion of the clinician. Fever recurred in only two of these patients after discharge, and there were no bacterial infections diagnosed after parenteral antibiotics were discontinued.

ConclusionEven without use of standard criteria for early discharge, clinicians appear to be skilled at selecting children with FN who can safely have IVAMT discontinued with an ANC ≤ 500 -mm.

List of abbreviationsAMCabsolute monocyte count

ANCabsolute neutrophil count

APCabsolute phagocyte count

°Cdegrees Celsius

FNfebrile neutropenia

IVAMTintravenous antimicrobial therapy

MDImicrobiologically defined infection

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Autor: Heather Hodgson-Viden - Paul E Grundy - Joan L Robinson

Fuente: https://link.springer.com/







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