Febrile neutropenia in children with cancer: a retrospective Norwegian multicentre study of clinical and microbiological outcome

Scand J Infect Dis. 2008;40(4):301-7. doi: 10.1080/00365540701670436.

Abstract

Our objective was to describe clinical and laboratory characteristics, treatment and outcome among Norwegian children with cancer suffering from chemotherapy-induced febrile neutropenia (FN). We retrospectively reviewed data on paediatric FN episodes in 7 Norwegian hospitals during a 2.5-y period. A total of 236 episodes of FN occurred in 95 children. Acute lymphoblastic leukaemia was the most common diagnosis (49 patients). Blood cultures yielded growth in 39 episodes (17%). Primary empirical antibiotic regimens could be assigned to 2 main groups: 1) benzylpenicillin or ampicillin and an aminoglycoside (58%) or 2) a regimen based on third-generation cephalosporins (42%). There were no statistically significant differences in outcome between the 2 regimens in terms of need to change initial antibiotic treatment, d of fever or maximum C-reactive protein values. One infection-related death (fungal septicaemia) occurred during the study period. We conclude that incidence of septicaemia and clinical outcome is similar to recent international trials on paediatric FN, but antibiotic treatment in Norway differs from international guidelines. However, patients in our study were successfully and safely treated, irrespective of the primary empirical antibiotic regimen.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Bacterial Infections / drug therapy
  • Bacterial Infections / microbiology
  • Child
  • Child, Preschool
  • Female
  • Fever* / chemically induced
  • Fever* / drug therapy
  • Fever* / epidemiology
  • Fever* / microbiology
  • Gram-Negative Bacteria / drug effects
  • Gram-Positive Bacteria / drug effects
  • Humans
  • Incidence
  • Male
  • Neoplasms / classification
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Neoplasms / epidemiology
  • Neutropenia* / chemically induced
  • Neutropenia* / drug therapy
  • Neutropenia* / epidemiology
  • Norway / epidemiology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / epidemiology
  • Prognosis
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Antineoplastic Agents