Document Detail

Home intravenous antibiotic treatment for febrile episodes in immune-compromised pediatric patients.
MedLine Citation:
PMID:  9403017     Owner:  NLM     Status:  MEDLINE    
The purpose of this work was to assess the feasibility of home intravenous antibiotic treatment (HIAT) for febrile episodes in immune-compromised (neutropenic, splenectomized), low-risk pediatric patients. Thirty hematology-oncology patients who presented to our emergency room from January 1993 to January 1995 and who suffered from a febrile episode and were considered at low risk for septic complications were immediately discharged on HIAT. Patients were followed for at least 3 weeks after recovery. Patients and parents were retrospectively questioned about adverse effects and about their degree of satisfaction with home treatment. Patients who required hospitalization during this period were considered unresponsive to HIAT and were analyzed for causes and adverse effects. Thirteen out of 60 (22%) febrile episodes, or eight out of 42 (19%) episodes of fever and neutropenia eventually led to hospitalization. Pseudomonas species infections were associated with the highest rate of unresponsiveness (88%). A central venous catheter infection developed in two cases following HIAT (two cases out of 640 days of therapy). No other complications were identified. No infection-related morbidity was observed. Patients and parents were highly satisfied with HIAT and wanted to use it again, if necessary. Immediate discharge on HIAT for low-risk pediatric immune-compromised patients suffering from a febrile episode is feasible, safe, and well accepted by patients and families. Patients who are found to have Pseudomonas infections should probably be hospitalized. Our results are preliminary and must be confirmed by a prospective, randomized trial before definite recommendations can be made.
E Shemesh; I Yaniv; M Drucker; S Hadad; Y Goshen; J Stein; S Ash; S Fisher; R Zaizov
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical and pediatric oncology     Volume:  30     ISSN:  0098-1532     ISO Abbreviation:  Med. Pediatr. Oncol.     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1997-12-31     Completed Date:  1997-12-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7506654     Medline TA:  Med Pediatr Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  95-100     Citation Subset:  IM    
National Center for Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Tel Aviv, Israel.
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MeSH Terms
Anti-Bacterial Agents / administration & dosage*,  adverse effects
Child, Preschool
Fever / drug therapy*
Home Infusion Therapy*
Immunocompromised Host
Infusions, Intravenous
Neutropenia / drug therapy*
Patient Satisfaction
Treatment Outcome
Reg. No./Substance:
0/Anti-Bacterial Agents

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