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Supportive Care in Cancer
Published in: Supportive Care in Cancer 6/2012

01-06-2012 | Review Article

Outpatient and oral antibiotic management of low-risk febrile neutropenia are effective in children—a systematic review of prospective trials

Authors: A. Manji, J. Beyene, L. L. Dupuis, R. Phillips, T. Lehrnbecher, L. Sung

Published in: Supportive Care in Cancer | Issue 6/2012

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.
Appendix
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Metadata
Title
Outpatient and oral antibiotic management of low-risk febrile neutropenia are effective in children—a systematic review of prospective trials
Authors
A. Manji
J. Beyene
L. L. Dupuis
R. Phillips
T. Lehrnbecher
L. Sung
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 6/2012
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-012-1425-8

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