Morgan, Jessica E, Hassan, Hadeel, Cockle, Julia V et al. (3 more authors) (2017) Critical review of current clinical practice guidelines for antifungal therapy in paediatric haematology and oncology. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. ISSN 1433-7339
Abstract
PURPOSE: The incidence of invasive fungal disease (IFD) is rising, but its treatment in paediatric haematology and oncology patients is not yet standardised. This review aimed to critically appraise and analyse the clinical practice guidelines (CPGs) that are available for paediatric IFD. METHODS: Electronic searches of MEDLINE, MEDLINE in-Process & Other non-Indexed Citations, the Guidelines International Network (GIN), guideline.gov and Google were performed and combined fungal disease (Fung* OR antifung*OR Candida* OR Aspergill*) with prophylaxis or treatment (prophyl* OR therap* OR treatment). All guidelines were assessed using the AGREE II tool and recommendations relating to prophylaxis, empirical treatment and specific therapy were extracted. RESULTS: Nineteen guidelines met the inclusion criteria. The AGREE II scores for the rigour of development domain ranged from 11 to 92 % with a median of 53 % (interquartile range 32-69 %). Fluconazole was recommended as antifungal prophylaxis in all nine of the included guidelines which recommended a specific drug. Liposomal amphotericin B was recommended in all five guidelines giving empirical therapy recommendations. Specific therapy recommendations were given for oral or genital candidiasis, invasive candida infection, invasive aspergillosis and other mould infections. CONCLUSIONS: In many areas, recommendations were clear about appropriate practice but further clarity was required, particularly relating to the decision to discontinue empirical antifungal treatment, the relative benefits of empiric and pre-emptive strategies and risk stratification. Future CPGs could consider working to published guideline production methodologies and sharing summaries of evidence appraisal to reduce duplication of effort, improving the quality and efficiency of CPGs in this area.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | ©Springer-Verlag Berlin Heidelberg 2016. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) The University of York > Faculty of Sciences (York) > Hull York Medical School (York) The University of York > Faculty of Social Sciences (York) > Centre for Reviews and Dissemination (York) |
Depositing User: | Pure (York) |
Date Deposited: | 19 Dec 2016 15:21 |
Last Modified: | 05 Feb 2025 00:06 |
Published Version: | https://doi.org/10.1007/s00520-016-3412-y |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1007/s00520-016-3412-y |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:109714 |
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