Antibiotic prophylaxis in neutropenic children with acute leukemia: Do the presently available data really support this practice?

Eur J Haematol. 2018 Dec;101(6):721-727. doi: 10.1111/ejh.13162. Epub 2018 Sep 24.

Abstract

Antibiotics are frequently administered for prophylaxis of fever in neutropenic children with cancer. This strategy is mainly derived from adults' data, and various pediatric studies evidenced the effectiveness of antibiotics (eg, fluoroquinolones) in the prevention of febrile neutropenia. However, only two pediatric randomized, double-blind, placebo-controlled trials have been performed, with a total of 262 leukemic children enrolled, and no other one was ever powered for analyzing effectiveness over other infectious complications. In an era of increasing antibiotic resistance, the widespread use of antibiotic prophylaxis in neutropenic leukemic children needs to be strongly supported.

Keywords: acute leukemia; antibiotic prophylaxis; febrile neutropenia; pediatrics.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bacterial Infections / etiology*
  • Bacterial Infections / prevention & control*
  • Child
  • Fever / etiology
  • Fever / prevention & control
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Humans
  • Leukemia, Myeloid, Acute / complications*
  • Leukemia, Myeloid, Acute / therapy
  • Neutropenia / complications*
  • Neutropenia / etiology*
  • Pediatrics

Substances

  • Anti-Bacterial Agents