SynthesisSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2020
Association of time to antibiotics and clinical outcomes in patients with fever and neutropenia during chemotherapy for cancer: a systematic review.
Synthesis in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 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
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Association of Time to Antibiotics With Outcome in Pediatric Patients Receiving Chemotherapy for Cancer With Fever in Neutropenia-An International Individual Patient Data Meta-Analysis.Cancer medicine · 2026Pooled it
- Interventions aiming to reduce time to antibiotics (TTA) in patients with fever and neutropenia during chemotherapy for cancer (FN), a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Pooled it
- Process Analysis of Time to Antibiotics in Pediatric Patients With Fever in Neutropenia During Chemotherapy for Cancer.Journal of pediatric hematology/oncology · 2026Article
- Continuous wireless temperature monitoring using TempTraq® in children.Pediatric research · 2026Article
- Therapeutic investigation of Jania rubens polysaccharides: antimicrobial activity and potentiation of chemotherapy in colorectal cancer cells.BMC complementary medicine and therapies · 2026Article
- Targeting Leukopoiesis: Pharmacological and Biotechnological Strategies for the Treatment of Leukopenia.Biomedicines · 2026Review
- Utilizing Process Mapping as a Framework for Identifying and Prioritizing Barriers to Antibiotic Delivery in Resource-limited Settings.Open forum infectious diseases · 2026Article
- Optimising door-to-needle-time in children with febrile neutropenia in the paediatric emergency unit-a quality improvement study.Ecancermedicalscience · 2026Article
- Vital signs continuously monitored by two wearable devices in pediatric oncology patients, NCT04914702.Scientific data · 2025Observational
- Implementation of Smart Triage combined with a quality improvement program for children presenting to facilities in Kenya and Uganda: An interrupted time series analysis.PLOS digital health · 2025Article
- Cathelicidin, but not vitamin D, is associated independently with sepsis in pediatric patients with cancer and febrile neutropenia.Molecular and clinical oncology · 2025Article
- Early antibiotics administration reduces mortality in sepsis patients in tertiary care hospital.BMC infectious diseases · 2025Article
- Severe outcomes and risk factors of non-neutropenic fever episodes in hospitalized children with cancer in Kenya.Frontiers in oncology · 2025Article
- Improving fever management of hospitalized children with cancer: barriers, facilitators, and proposed interventions from healthcare providers in Kenya.Frontiers in oncology · 2025Article
- Impact of time to antibiotics on clinical outcome in paediatric febrile neutropenia: a target trial emulation of 1685 episodes.The Lancet regional health. Western Pacific · 2024Article
- Continuous timely monitoring of core temperature with two wearable devices in pediatric patients undergoing chemotherapy for cancer - a comparison study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Observational
- Impact of Time-to-Antibiotic Delivery in Pediatric Patients With Cancer Presenting With Febrile Neutropenia.JCO oncology practice · 2024Article
- Distinct clinical phenotypes in paediatric cancer patients with sepsis are associated with different outcomes-an international multicentre retrospective study.EClinicalMedicine · 2023Article
- Time to antibiotics is unrelated to outcome in pediatric patients with fever in neutropenia presenting without severe disease during chemotherapy for cancer.Scientific reports · 2022Article
- A modified emergency severity index level is associated with outcomes in cancer patients with COVID-19.The American journal of emergency medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
Abstract
purposePrompt antibiotic therapy is standard of care for patients with fever and neutropenia (FN) during chemotherapy for cancer. We systematically reviewed the association between time to antibiotics (TTA) and clinical outcomes.
methodsThe search covered seven databases; confounding biases and study quality were assessed with the ROBINS-I tool. Safety (death, intensive care unit (ICU) admission, sepsis) and treatment adequacy (relapse of infection, persistence or recurrence of fever) were assessed as primary outcomes.
resultsOf 6296 articles identified, 13 observational studies were included. Findings regarding safety were inconsistent. Three studies controlling for triage bias showed a possible association between longer TTA and impaired safety. Meta-analysis for TTA ≤ 60 min versus > 60 min was feasible on four studies, with three studies each reporting on death (OR 0.78, 95%CI 0.16-3.69) and on ICU admission (OR 1.43, 95%CI 0.57-3.60). No study reported data on treatment adequacy. Triage bias, i.e. faster treatment of patients with worse clinical condition, was identified as a relevant confounding factor.
conclusionThere seems to be an association between longer TTA and impaired safety. More knowledge about TTA effects on safety are important to optimise treatment guidelines for FN. Controlling for triage and other biases is necessary to gain further evidence.
trial registrationRegistration: PROSPERO [http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018092948].
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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.