SynthesisThe Cochrane database of systematic reviews2009
Prophylactic antibiotics or G-CSF for the prevention of infections and improvement of survival in cancer patients undergoing chemotherapy.
Synthesis in The Cochrane database of systematic reviews, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- Quality indicators for systemic anticancer therapy services: a systematic review of metrics used to compare quality across healthcare facilities.European journal of cancer (Oxford, England : 1990) · 2023Pooled it
- A systematic review and critical assessment of incentive strategies for discovery and development of novel antibiotics.The Journal of antibiotics · 2016Pooled it
- Guideline
- Primary prophylactic colony-stimulating factors for the prevention of chemotherapy-induced febrile neutropenia in breast cancer patients.The Cochrane database of systematic reviews · 2012Pooled it
- 8MW0511, a novel, long-acting granulocyte-colony stimulating factor fusion protein for the prevention of chemotherapy-induced neutropenia: final results from the phase III clinical trial.Breast cancer research : BCR · 2025Trial
- Early switch from intravenous to oral antibiotic therapy in patients with cancer who have low-risk neutropenic sepsis: the EASI-SWITCH RCT.Health technology assessment (Winchester, England) · 2024Trial
- In-hospital mortality prognostication for cancer patients with febrile neutropenia.Communications medicine · 2025Article
- Successful Management of Neutropenic Sepsis Is Key to Better Survival of Patients With Blood Cancer in Sri Lanka: Real-World Data From the Resource-Limited Setting.JCO global oncology · 2024Article
- Case Report: Resolution of high grade anal squamous intraepithelial lesion with antibiotics proposes a new role for syphilitic infection in potentiation of HPV-associated ASCC.Frontiers in oncology · 2023Article
- Rapid Administration of Antibiotics for Reducing Fever Days in Patients Receiving Hematopoietic Stem Cell Transplantation.Medicina (Kaunas, Lithuania) · 2022Article
- Article
- Improving door to needle time in neutropenic sepsis.Future healthcare journal · 2020Article
- The first report on theSaudi journal of biological sciences · 2019Article
- The timeliness of patients reporting the side effects of chemotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2018Article
- Cost of Cancer-Related Neutropenia or Fever Hospitalizations, United States, 2012.Journal of oncology practice · 2017Article
- Chasing the Golden Hour - Lessons learned from improving initial neutropenic sepsis management.BMJ quality improvement reports · 2017Article
- Impact of an electronic tool in prescribing primary prophylaxis with ciprofloxacin or granulocyte colony-stimulating factor for breast cancer patients receiving TC chemotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2016Article
- Granulocyte Colony-Stimulating Factor Use in a Large Iranian Hospital: Comparison with American Society of Clinical Oncology (ASCO) Clinical Practice Guideline.International journal of hematology-oncology and stem cell research · 2016Article
- Attitudes and practice patterns for maintaining relative dose intensity of chemotherapy in outpatient clinics: results of a Japanese web-based survey.BMC cancer · 2015Article
- The signs, symptoms and help-seeking experiences of neutropenic sepsis patients before they reach hospital: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2015Article
Corrections and comments
- Updated by
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFebrile neutropenia (FN) and other infectious complications are some of the most serious treatment-related toxicities of chemotherapy for cancer, with a mortality rate of 2% to 21%. The two main types of prophylactic regimens are granulocyte (G-CSF) or granulocyte-macrophage colony stimulating factors (GM-CSF); and antibiotics, frequently quinolones or cotrimoxazole. Important current guidelines recommend the use of colony stimulating factors when the risk of febrile neutropenia is above 20% but they do not mention the use of antibiotics. However, both regimens have been shown to reduce the incidence of infections. Since no systematic review has compared the two regimens, a systematic review was undertaken.
objectivesTo compare the effectiveness of G-CSF or GM-CSF with antibiotics in cancer patients receiving myeloablative chemotherapy with respect to preventing fever, febrile neutropenia, infection, infection-related mortality, early mortality and improving quality of life. SEARCH STRATEGY: We searched The Cochrane Library, MEDLINE, EMBASE, databases of ongoing trials, and conference proceedings of the American Society of Clinical Oncology and the American Society of Hematology (1980 to 2007). We planned to include both full-text and abstract publications. SELECTION CRITERIA: Randomised controlled trials comparing prophylaxis with G-CSF or GM-CSF versus antibiotics in cancer patients of all ages receiving chemotherapy or bone marrow or stem cell transplantation were included for review. Both study arms had to receive identical chemotherapy regimes and other supportive care. DATA COLLECTION AND ANALYSIS: Trial eligibility and quality assessment, data extraction and analysis were done in duplicate. Authors were contacted to obtain missing data. MAIN
resultsWe included two eligible randomised controlled trials with 195 patients. Due to differences in the outcomes reported, the trials could not be pooled for meta-analysis. Both trials showed non-significant results favouring antibiotics for the prevention of fever or hospitalisation for febrile neutropenia. AUTHORS'
conclusionsThere is no evidence for or against antibiotics compared to G(M)-CSFs for the prevention of infections in cancer patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.