title: Febrile neutropenia in children with cancer: a retrospective Norwegian multicentre study of clinical and microbiological outcome.
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.
authors.affiliation: Department of Paediatrics, University Hospital of North Norway, N-9038 Tromsø, Norway. niklas.stabell@unn.no
authors.forename: Niklas
authors.initials: N
authors.lastname: Stabell
authors.forename: Ellen
authors.initials: E
authors.lastname: Nordal
authors.forename: Einar
authors.initials: E
authors.lastname: Stensvold
authors.forename: Karianne Wiger
authors.initials: KW
authors.lastname: Gammelsrud
authors.forename: Bendik
authors.initials: B
authors.lastname: Lund
authors.forename: Arne
authors.initials: A
authors.lastname: Taxt
authors.forename: Frauke
authors.initials: F
authors.lastname: Buhring
authors.forename: Margrethe
authors.initials: M
authors.lastname: Greve-Isdahl
authors.forename: Hans Petter
authors.initials: HP
authors.lastname: Fornebo
authors.forename: Gunnar Skov
authors.initials: GS
authors.lastname: Simonsen
authors.forename: Claus
authors.initials: C
authors.lastname: Klingenberg
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006094:Gram-Positive Bacteria / Q000187:drug effects; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000145:classification / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy / Q000453:epidemiology; D009664:Norway / Q000453:epidemiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents