Morgan, Jessica Elizabeth and Phillips, Bob orcid.org/0000-0002-4938-9673 (2022) PAnTher Cub:procalcitonin-guided antibiotic therapy for febrile neutropenia in children and young people with cancer - a single-arm pilot study. BMJ paediatrics open. e001339. ISSN 2399-9772
Abstract
BACKGROUND: Febrile neutropenia (FN) is a common complication of cancer treatment in children and young people, and many episodes are over-treated. Procalcitonin, may be an appropriate tool to guide the stopping of antibiotics in those at low risk of serious bacterial infection. Supportive care trials in this population have proven to be difficult to undertake. This single-arm pilot study aimed to evaluate whether a study using a procalcitonin-guided stopping-rule for antibiotics in paediatric FN is possible. METHODS: Daily procalcitonin levels were performed during episodes of FN and clear guidance given for antibiotic discontinuation. Episode data and quantitative feasibility data were collected alongside interviews with professionals and ethnographic observations. Analysis was descriptive. RESULTS: Of 32 patients and families approached, 28 patients consented, and 13 had febrile neutropenia. In total, 16 episodes were included in the study. All relevant FN episodes had data captured, with adequate data collection. There were no significant safety events. In 4/8 (50%) of episodes without clear microbiologically documented or clinical infection, antibiotics were reduced in duration or in spectrum. Interviews with professionals revealed the importance of the research, the value of key individuals in the study team, particular challenges of this protocol and suggestions for study improvements. CONCLUSIONS: Studies to evaluate procalcitonin-guided approaches to stopping antibiotics in paediatric FN are possible.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © Author(s) (or their employer(s)) 2022 |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Reviews and Dissemination (York) The University of York > Faculty of Sciences (York) > Hull York Medical School (York) |
Depositing User: | Pure (York) |
Date Deposited: | 09 Sep 2022 11:50 |
Last Modified: | 21 Jan 2025 18:04 |
Published Version: | https://doi.org/10.1136/bmjpo-2021-001339 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1136/bmjpo-2021-001339 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:190881 |
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Filename: e001339.full.pdf
Description: PAnTher Cub: procalcitonin-guided antibiotic therapy for febrile neutropenia in children and young people with cancer - a single-arm pilot study
Licence: CC-BY-NC 2.5