Compliance with anti-infective preventive measures: A multicentre survey among paediatric oncology patients

Lehrnbecher, Thomas; Laws, Hans‐Jürgen; Boehm, Alexandra; Dworzak, Michael; Janßen, Gisela; Simon, Arne; Groll, Andreas H.

doi:10.1016/j.ejca.2008.06.022

Cited by 26 publications

(23 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Notably, the use of mould-active antifungal triazoles such as itraconazole or voriconazole for prophylaxis in children is limited by the interaction with vinca alkaloids, which constitute a cornerstone in the treatment of paediatric leukaemia [5,6]. In addition, a recent survey reported on low compliance of children on itraconazole prophylaxis [18]. Echinocandins are associated with fewer side effects [19][20][21] than LAMB.…”

Section: Discussionmentioning

confidence: 98%

Liposomal amphotericin B twice weekly as antifungal prophylaxis in paediatric haematological malignancy patients

Bochennek

Tramsen

Schedler

et al. 2011

Clinical Microbiology and Infection

View full text Add to dashboard Cite

Data on antifungal prophylaxis in paediatric cancer patients at high risk for invasive fungal disease (IFD) are scant. Intermittent administration of liposomal amphotericin B (LAMB) has been shown to be safe and effective in adult patients with haematological malignancies. We prospectively evaluated the safety and efficacy of prophylactic LAMB at a dosage of 2.5 mg/kg twice weekly in children at high risk for IFD. Efficacy was compared with that in a historical control group of patients with similar demographic characteristics not receiving LAMB prophylaxis. A total of 46 high-risk patients (24 boys; mean age, 7.7 years) with 187 episodes of antifungal prophylaxis were analysed. The median duration of neutropenia (<500/μL) was 10 days. LAMB was discontinued in four patients because of acute allergic reactions. Median values for creatinine and liver enzymes at end of treatment did not differ significantly from those at baseline. Hypokalaemia (<3.0 mmol/L) occurred with 13.5% of the prophylactic episodes, but was usually mild and always reversible. No proven/probable IFD occurred in patients receiving LAMB prophylaxis. In comparison, five proven and two probable IFDs were observed in 45 historical controls not receiving LAMB prophylaxis (p 0.01). LAMB prophylaxis had no impact on the use of empirical antifungal therapy. Systemic antifungal prophylaxis with LAMB 2.5 mg/kg twice weekly is feasible and safe, and seems to be an effective approach for antifungal prophylaxis in high-risk paediatric cancer patients.

show abstract

Section: Discussionmentioning

confidence: 98%

Liposomal amphotericin B twice weekly as antifungal prophylaxis in paediatric haematological malignancy patients

Bochennek

Tramsen

Schedler

et al. 2011

Clinical Microbiology and Infection

View full text Add to dashboard Cite

show abstract

“…Restrictions under certain circumstances are mostly related to neutropenia (58%) and to chemotherapy regimens (e.g., more restrictions during induction; 17%). The health of surrounding people (friends without cold allowed to visit, school only if others Variations in non-pharmacological anti-infective measures haematologica | 2012; 97 (10)are healthy, etc.) is a common pre-condition for reduced restrictions (16%).…”

Section: Resultsmentioning

confidence: 99%

“…10 The summary restriction score was a maximum of 12 for social contacts (6 items), 16 for food (8 items) and 10 for pets (5 items), with higher numbers representing more restrictions.…”

Section: Design and Methodsmentioning

confidence: 99%

“…7,8 Secondly, since restrictions may negatively affect the quality of life of children and their families, variability in supportive care measures may ultimately result in dissatisfaction of patients and lower compliance. 10 On the other hand, we may be able to describe comparative effectiveness of such practices if we could identify institutions that are otherwise similar with different practices although such an analysis would be highly susceptible to confounding variables. Finally, this variability highlights the need for evidence-based guidelines regarding these issues.…”

Section: Number Of Centers Responding (% Of Total Centers)/ Number Ofmentioning

confidence: 99%

“…However, non-pharmacological approaches may reduce quality of life and increase burden of care from both an institutional and parental perspective. 10 In contrast to pharmacological strategies, almost nothing is known about variability in non-pharmacological anti-infective practices in children with cancer. This knowledge is, however, important as it may help centers to benchmark their own practices and it may highlight where research could be feasible and useful.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Variations in non-pharmacological anti-infective measures in childhood leukemia - results of an international survey

et al. 2012

View full text Add to dashboard Cite

The online version of this article has a Supplementary Appendix. BackgroundStandardization in clinical practice may lead to improved outcomes. Unfortunately, little is known about the variability of non-pharmacological anti-infective measures in children with cancer. Design and MethodsA web-based survey assessed institutional recommendations regarding restrictions of social contacts, pets and food and instructions on wearing face masks in public for children with standard-risk acute lymphoblastic leukemia and acute myeloid leukemia during intensive chemotherapy. ResultsA total of 336 institutions in 27 countries responded to the survey (range, 1-76 institutions per country; overall response rate 61%). Most institutions recommend that patients with acute myeloid leukemia avoid indoor public places and daycare, kindergarten and school, whereas recommendations for patients with acute lymphoblastic leukemia differ considerably by institution. In terms of restrictions related to pets, there was a wide variability between institutions for both acute lymphoblastic and acute myeloid leukemia patients. Most, but not all institutions do not allow children with either acute lymphoblastic or acute myeloid leukemia to eat raw meat, raw seafood or unpasteurized milk. Whereas most institutions do not routinely recommend that patients with acute lymphoblastic leukemia wear face masks in public, advice on this matter varies for patients with acute myeloid leukemia. ConclusionsThe survey demonstrates that there is a wide variation in recommendations on non-pharmacological anti-infective measures between different institutions, countries and continents. This information may be used to encourage harmonization of supportive care practices and future clinical trials.

show abstract

Infektiöse Komplikationen bei akuter lymphatischer Leukämie

Lehrnbecher

2012

Pharmazie in unserer Zeit

View full text Add to dashboard Cite

Mit immer intensiveren Therapien versucht man die Heilungsrate bei Kindern mit Leukämien zu verbessern. Durch die Therapie‐Intensivierung wird jedoch gleichzeitig auch eine zunehmende Immunsuppression hervorgerufen, sodass infektiöse Komplikationen trotz Verbesserungen in der Supportivtherapie noch immer eine wichtige Ursache für Morbidität und Mortalität bei Kindern mit akuter lymphatischer Leukämie (ALL) darstellen.

show abstract

Compliance with anti-infective preventive measures: A multicentre survey among paediatric oncology patients

Cited by 26 publications

References 23 publications

Liposomal amphotericin B twice weekly as antifungal prophylaxis in paediatric haematological malignancy patients

Liposomal amphotericin B twice weekly as antifungal prophylaxis in paediatric haematological malignancy patients

Variations in non-pharmacological anti-infective measures in childhood leukemia - results of an international survey

Infektiöse Komplikationen bei akuter lymphatischer Leukämie

Contact Info

Product

Resources

About