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Time to antibiotics is unrelated to outcome in pediatric patients with fever in neutropenia presenting without severe disease during chemotherapy for cancer.

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cris.virtual.author-orcid0000-0002-8339-5444
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cris.virtual.author-orcid0000-0003-4022-4917
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cris.virtualsource.author-orcid3857e2d3-2b7f-42b6-878d-ce868ac1673c
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cris.virtualsource.author-orcid34519da0-a4bd-4bbc-8a97-e6cf0bff6325
dc.contributor.authorKönig, Christa
dc.contributor.authorKühni, Claudia
dc.contributor.authorBodmer, Nicole
dc.contributor.authorAgyeman, Philipp Kwame Abayie
dc.contributor.authorAnsari, Marc
dc.contributor.authorRössler, Jochen Karl
dc.contributor.authorvon der Weid, Nicolas X
dc.contributor.authorAmmann, Roland
dc.date.accessioned2024-10-11T17:03:57Z
dc.date.available2024-10-11T17:03:57Z
dc.date.issued2022-08-18
dc.description.abstractFever in neutropenia (FN) remains an unavoidable, potentially lethal complication of chemotherapy. Timely administration of empirical broad-spectrum intravenous antibiotics has become standard of care. But the impact of time to antibiotics (TTA), the lag period between recognition of fever or arrival at the hospital to start of antibiotics, remains unclear. Here we aimed to analyze the association between TTA and safety relevant events (SRE) in data from a prospective multicenter study. We analyzed the association between time from recognition of fever to start of antibiotics (TTA) and SRE (death, admission to intensive care unit, severe sepsis and bacteremia) with three-level mixed logistic regression. We adjusted for possible triage bias using a propensity score and stratified the analysis by severity of disease at presentation with FN. We analyzed 266 FN episodes, including 53 (20%) with SRE, reported in 140 of 269 patients recruited from April 2016 to August 2018. TTA (median, 120 min; interquartile range, 49-180 min) was not associated with SRE, with a trend for less SREs in episodes with longer TTA. Analyses applying the propensity score suggested a relevant triage bias. Only in patients with severe disease at presentation there was a trend for an association of longer TTA with more SRE. In conclusion, TTA was unrelated to poor clinical outcome in pediatric patients with FN presenting without severe disease. We saw strong evidence for triage bias which could only be partially adjusted.
dc.description.numberOfPages9
dc.description.sponsorshipUniversitätsklinik für Kinderheilkunde
dc.description.sponsorshipInstitut für Sozial- und Präventivmedizin (ISPM)
dc.identifier.doi10.48350/172226
dc.identifier.pmid35982121
dc.identifier.publisherDOI10.1038/s41598-022-18168-x
dc.identifier.urihttps://boris-portal.unibe.ch/handle/20.500.12422/86891
dc.language.isoen
dc.publisherNature Publishing Group
dc.relation.ispartofScientific Reports
dc.relation.issn2045-2322
dc.relation.organizationDCD5A442BADAE17DE0405C82790C4DE2
dc.relation.organizationDCD5A442BB22E17DE0405C82790C4DE2
dc.relation.organizationDCD5A442BB24E17DE0405C82790C4DE2
dc.relation.organizationDCD5A442BECFE17DE0405C82790C4DE2
dc.relation.organizationDCD5A442C607E17DE0405C82790C4DE2
dc.subject.ddc600 - Technology::610 - Medicine & health
dc.subject.ddc300 - Social sciences, sociology & anthropology::360 - Social problems & social services
dc.subject.ddc500 - Science::570 - Life sciences; biology
dc.titleTime to antibiotics is unrelated to outcome in pediatric patients with fever in neutropenia presenting without severe disease during chemotherapy for cancer.
dc.typearticle
dspace.entity.typePublication
dspace.file.typetext
oaire.citation.issue1
oaire.citation.startPage14028
oaire.citation.volume12
oairecerif.author.affiliationUniversitätsklinik für Kinderheilkunde
oairecerif.author.affiliationInstitut für Sozial- und Präventivmedizin (ISPM)
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oairecerif.author.affiliationUniversitätsklinik für Kinderheilkunde
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oairecerif.author.affiliationUniversitätsklinik für Kinderheilkunde
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oairecerif.author.affiliationUniversitätsklinik für Kinderheilkunde
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unibe.date.licenseChanged2022-08-22 07:59:14
unibe.description.ispublishedpub
unibe.eprints.legacyId172226
unibe.journal.abbrevTitleSci Rep
unibe.refereedTRUE
unibe.subtype.articlejournal

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