Cessation of antibiotics regardless of ANC is safe in children with febrile neutropenia: A preliminary prospective trial

J. Kennenth, Karen Leamer, Lorrie Odom, Brian Greffe, Linda Stork

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

Purpose: This study was designed to evaluate the safety and efficacy of stopping antibiotic treatment regardless of absolute neutrophil count (ANC) or signs of impending neutrophil recovery in children with febrile neutropenia (FN) and no identifiable infectious source. Patients and Methods: Thirty-two consecutive cases of FN without identifiable source were prospectively evaluated. Patients were examined, cultured, and initially treated with ceftazidime ± vancomycin. Antibiotics were discontinued and patients discharged regardless of ANC (WBC/μl X [% segs + bands]) once all the following criteria were met: Afebrile × 24 h; cultures negative at 48 h; thermometer and telephone available at home. Prompt notification of fever (T > 38.3°C) and readmission were required. Results: Median ANC was 60/μl on admission and 160/μl at discharge. Median length of treatment was 3 days. Four patients were readmitted for FN, and two patients were readmitted afebrile for cultures which became positive after discharge. None of the 32 cases suffered apparent complications from early discharge. Conclusion: Results of this preliminary trial suggest that cessation of antibiotics regardless of ANC is safe in cases of FN without identifiable source, provided that marrow is not infiltrated and that recurrent fever receives prompt antibiotic retreatment.

Original languageEnglish (US)
Pages (from-to)325-330
Number of pages6
JournalJournal of Pediatric Hematology/Oncology
Volume17
Issue number4
DOIs
StatePublished - Nov 1995

Keywords

  • Antibiotics
  • Fever
  • Hospitalization
  • Infections
  • Malignancy
  • Neoplasms
  • Neutropenia
  • Pediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

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