Abstract | OBJECTIVE: STUDY DESIGN: Episodes of fever without neutropenia (absolute neutrophil count [ANC] ≥500 cells/mm(3)) were reviewed retrospectively in pediatric oncology patients with a CVC undergoing chemotherapy. Characteristics and symptoms were compared between patients with bacteremia and patients without bacteremia. RESULTS: A total of 392 episodes of nonneutropenic fever in 138 subjects (52 females; 38%) were reviewed. In this cohort, the median age at an episode was 7 years, and the majority of patients had a diagnosis of acute leukemia (54%). Median ANC was 3100 cells/mm(3) (IQR, 1570-5980 cells/mm(3)). Median temperature was 38.7°C (IQR, 38.3-39.2°C). Twenty-four infectious episodes (6%) occurred in 18 subjects, and 5 CVCs required removal; all patients requiring removal admitted and received antibiotics owing to chills. There were no significant difference in age, sex, or ANC between patients with bacteremia and those without bacteremia; however, mean temperature was higher in the patients with bacteremia (39.4°C vs 38.7°C; P = .003). No deaths due to sepsis occurred, and no CVCs were removed because antibiotics were not administered empirically. CONCLUSION: Our practice of observing pediatric oncology patients undergoing chemotherapy with CVCs who are not neutropenic does not appear to lead to increased serious adverse outcomes and avoids antibiotic exposure for >90% of patients without a bacterial infection.
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Authors | Frederick Bartholomew, Catherine Aftandilian, Jennifer Andrews, Kathleen Gutierrez, Sandra Luna-Fineman, Michael Jeng |
Journal | The Journal of pediatrics
(J Pediatr)
Vol. 166
Issue 1
Pg. 157-62
(Jan 2015)
ISSN: 1097-6833 [Electronic] United States |
PMID | 25444524
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2015 Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Adolescent
- Anti-Bacterial Agents
(therapeutic use)
- Bacteremia
(drug therapy)
- Bacterial Infections
(drug therapy)
- Central Venous Catheters
- Child
- Child, Preschool
- Female
- Fever
(drug therapy)
- Humans
- Infant
- Male
- Neoplasms
(complications)
- Neutropenia
(complications)
- Retrospective Studies
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