Outpatient versus inpatient IV antibiotic management for pediatric oncology patients with low risk febrile neutropenia: A randomised trial

Orme, Lisa; Babl, Franz E; Barnes, Chris; Barnett, Peter; Donath, Susan; Ashley, David M.

doi:10.1002/pbc.25012

Cited by 61 publications

(59 citation statements)

References 31 publications

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“…These data suggest that, with structured low‐risk programmes incorporating risk assessment, regular observation and appropriate safeguards, many more low‐risk patients would benefit from reduced‐intensity home‐based care. Such treatment has been shown to be safe, improve quality of life and is significantly less expensive than routine inpatient care …”

Section: Discussionmentioning

confidence: 99%

Management of fever and neutropenia in children with cancer: A survey of Australian and New Zealand practice

Haeusler

Slavin

Bryant

et al. 2018

J Paediatrics Child Health

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Section: Discussionmentioning

confidence: 99%

Management of fever and neutropenia in children with cancer: A survey of Australian and New Zealand practice

Haeusler

Slavin

Bryant

et al. 2018

J Paediatrics Child Health

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“…Compared with hospital admission, there are a number of potential benefits for the patient of being at home, including improved psychological outcomes, less disruption to family life and reduced hospital-acquired infections1 2 There are also benefits to the healthcare system, including improved patient flow and greater cost-effectiveness for the same management 3. With changing models of care and greater financial pressure on hospitals, the impetus for home-based care is likely to increase.…”

Section: Introductionmentioning

confidence: 99%

The use, appropriateness and outcomes of outpatient parenteral antimicrobial therapy

et al. 2016

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Objective Outpatient parenteral antimicrobial therapy (OPAT) is increasingly used to treat children at home, but studies in children are scarce. We aimed to describe the use, appropriateness and outcomes of OPAT in children. Design This was a 12-month prospective observational study. Setting The hospital-in-the-home programme of The Royal Children's Hospital Melbourne. Patients All patients receiving OPAT. Interventions Data were collected including demographics, diagnosis, type of venous access and antibiotic choice. Main outcome measures Length of stay, adverse events, readmission rate and appropriateness of antibiotic use. Results 228 patients received OPAT in 251 episodes. The median age was 7.4 years (range 1 week to 21 years), with 22 patients (10%) under 1 year. The most frequent diagnoses were exacerbation of cystic fibrosis (17%), urinary tract infection (12%) and cellulitis (9%). Most patients were transferred from the ward, but 18% were transferred directly from the emergency department, the majority with skin and soft-tissue infection (66%). Venous access was most commonly peripherally inserted central catheter (29%) and peripheral cannula (29%). 309 parenteral antibiotics were prescribed, most frequently ceftriaxone (28%) and gentamicin (19%). The majority of antibiotics (72%) were prescribed appropriately. However, 6% were deemed an inappropriate choice for the indication and 26% had inappropriate dose or duration. The incidence of central line-associated bloodstream infections was 0.9%. The unplanned readmission rate was 4%, with low rates of OPAT-related adverse events. Three children (1%) had an inadequate clinical response. Conclusions OPAT is a safe and effective way of providing antibiotics to children. Despite high rates of appropriate antibiotic use, improvements can still be made. BACKGROUND

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“…Disrupted child sleep was reported across multiple sleep assessment techniques including wrist actigraphy , parent sleep diaries , and child sleep diaries . Two studies used unvalidated self‐report questionnaires to ask children about their sleep quality , and one study used a mixed‐methods approach including parent‐proxy questionnaires and a qualitative interview —these measures also revealed disrupted sleep.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of sleep in hospitalized pediatric cancer patients

et al. 2016

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Investigations into the sources of increased sleep difficulties can be used to inform hospital procedures to create a more supportive sleep environment and more effective screening tools for patients who may be at greater risk for sleep difficulties. This may help to minimize the role that hospitalization plays in precipitating and perpetuating chronic sleep disturbances in pediatric cancer patients. Copyright © 2016 John Wiley & Sons, Ltd.

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Outpatient versus inpatient IV antibiotic management for pediatric oncology patients with low risk febrile neutropenia: A randomised trial

Abstract: Outpatient cefepime management of LRFN provided significant benefit to parents and patients across several QOL domains and appeared both feasible and safe.

Cited by 61 publications

References 31 publications

Management of fever and neutropenia in children with cancer: A survey of Australian and New Zealand practice

Management of fever and neutropenia in children with cancer: A survey of Australian and New Zealand practice

The use, appropriateness and outcomes of outpatient parenteral antimicrobial therapy

A systematic review of sleep in hospitalized pediatric cancer patients

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