Italian guidelines for the management of infectious complications in pediatric oncology: Empirical antimicrobial therapy of febrile neutropenia

C. Viscoli, E. Castagnola, M. Caniggia, L. De Sio, A. Garaventa, M. Giacchino, P. Indolfi, G. C. Izzi, P. Manzoni, M. R. Rossi, N. Santoro, G. A. Zanazzo, G. Masera

Research output: Contribution to journalArticle

Abstract

The Italian Association for Paediatric Haematology and Oncology prepared a guideline document aimed at unifying and rationalising as much as possible the management of febrile neutropenia in children with cancer, because of the potential impact of these procedures on hospital costs and on the development of antibiotic resistance. Before starting anti-infective therapy, at least 2 blood cultures, a throat swab, urine-culture, and cultures from any suspected infected site, should be performed. Routine chest X-rays at onset of febrile neutropenia are probably not necessary, in absence of respiratory signs. At the present time, the safer option probably remains the combination of a beta-lactam and an aminoglycoside, and treating febrile neutropenia outside of hospital should be considered an investigational approach. The choice of the most appropriated regimen for each institution should be based also on the local bacteriological statistics and patterns of bacterial resistance. Antibiotic toxicity and cost should be other important factors. Every subsequent addition or substitution of antibiotics should be based on objective signs of clinical deterioration. The only accepted empirical modification is empirical antifungal therapy, while the empirical addition of a glycopeptide antibiotic cannot be recommended.

Original languageEnglish
Pages (from-to)489-500
Number of pages12
JournalOncology
Volume55
Issue number5
Publication statusPublished - Sep 1998

Keywords

  • Cancer
  • Fever
  • Neutropenia
  • Pediatrics
  • Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Viscoli, C., Castagnola, E., Caniggia, M., De Sio, L., Garaventa, A., Giacchino, M., Indolfi, P., Izzi, G. C., Manzoni, P., Rossi, M. R., Santoro, N., Zanazzo, G. A., & Masera, G. (1998). Italian guidelines for the management of infectious complications in pediatric oncology: Empirical antimicrobial therapy of febrile neutropenia. Oncology, 55(5), 489-500.