Observational studyJCO global oncology2021
The Golden Hour: Sustainability and Clinical Outcomes of Adequate Time to Antibiotic Administration in Children with Cancer and Febrile Neutropenia in Northwestern Mexico.
Observational study in JCO global oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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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
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 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
- Process Analysis of Time to Antibiotics in Pediatric Patients With Fever in Neutropenia During Chemotherapy for Cancer.Journal of pediatric hematology/oncology · 2026Article
- Implementation of an electronic registry to monitor quality of care for febrile episodes in pediatric patients with cancer in Central America and the Caribbean.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Disseminating a Pediatric Oncology Critical Care Intervention in Latin America and Spain: An Integrated-Knowledge-Translation Approach.Global implementation research and applications · 2026Article
- Granulocyte colony-stimulating factor-induced hypersensitivity reaction with leukocytosis in a pediatric germ cell tumor patient: a case report.Frontiers in pediatrics · 2026Article
- Optimising door-to-needle-time in children with febrile neutropenia in the paediatric emergency unit-a quality improvement study.Ecancermedicalscience · 2026Article
- Article
- Building a transdisciplinary network to improve survival in children with cancer in Colombia: seeds to forests.Revista panamericana de salud publica = Pan American journal of public health · 2025Article
- Building and sustaining infection prevention and control teams at two pediatric cancer units in Ecuador and Guatemala through a collaboration partnership.Frontiers in oncology · 2025Article
- Overcoming challenges to reduce time to antibiotic therapy in febrile neutropenic children: insights from a Mexican center.Hematology, transfusion and cell therapy · 2024Article
- Impact of Time-to-Antibiotic Delivery in Pediatric Patients With Cancer Presenting With Febrile Neutropenia.JCO oncology practice · 2024Article
- Blood plasma metagenomic next-generation sequencing for identifying pathogens of febrile neutropenia in acute leukemia patients.Scientific reports · 2023Article
- Childhood Leukemia Survival in the US-Mexico Border: Building Sustainable Leukemia Care Using Health Systems Strengthening Models.JCO global oncology · 2023Article
- Collaboration for success: the Global Initiative for Childhood Cancer in Latin America.Revista panamericana de salud publica = Pan American journal of public health · 2023Article
- A multimodal strategy to improve health care for pediatric patients with cancer and fever in Peru.Revista panamericana de salud publica = Pan American journal of public health · 2023Article
- Advances in the Global Initiative for Childhood Cancer: implementation in Latin America and the Caribbean.Revista panamericana de salud publica = Pan American journal of public health · 2023Article
- Evaluation of factors leading to poor outcomes for pediatric acute lymphoblastic leukemia in Mexico: a multi-institutional report of 2,116 patients.Frontiers in oncology · 2023Article
- Securing access to a comprehensive diagnostic panel for children with suspected acute lymphoblastic leukemia: Results from the Mexico in Alliance with St. Jude "Bridge Project".Frontiers in oncology · 2023Article
- The PRINCIPAL Network: A Model to Optimize Infection Care and Prevention in Pediatric Oncology in the Latin American Region.JCO global oncology · 2022Article
- Diagnosis and Management of Febrile Neutropenia in Pediatric Oncology Patients-A Systematic Review.Diagnostics (Basel, Switzerland) · 2022Review
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
Abstract
purposeTime to antibiotic administration (TTA) is a commonly used standard of care in pediatric cancer settings in high-income countries. Effective interventions to improve outcomes in cancer patients with febrile neutropenia (FN) often address timely and appropriate antibiotic administration. We assessed the effectiveness of a locally adapted multimodal strategy in decreasing TTA in a resource-constrained pediatric cancer center in Mexico.
methodsWe conducted a prospective observational study between January 2014 and April 2019. A three-phase (phase I: execution, phase II: consolidation, phase III: sustainability) multimodal improvement strategy that combined system change, FN guideline development, education, auditing and monitoring, mentoring, and dissemination was implemented to decrease TTA in inpatient and ambulatory areas. Sustainability factors were measured by using a validated tool during phases I and III.
resultsOur population included 105 children with cancer with 204 FN events. The baseline assessment revealed that only 50% of patients received antibiotics within 60 minutes of prescription (median time: inpatient, 75 minutes; ambulatory, 65 minutes). After implementing our improvement strategy, the percentage of patients receiving antibiotics within 60 minutes of prescription increased to 88%. We significantly decreased median TTA in both clinical areas during the three phases of the study. In phase III (sustainability), the median TTA was 40 minutes (
conclusionOur results demonstrate that locally adapted multimodal interventions can reduce TTA in resource-constrained settings. Mentoring and dissemination were novel components of the multimodal strategy to improve FN-associated clinical outcomes. Improving local infrastructure, ongoing monitoring systems, and leadership engagement have been key factors to achieving sustainability during the 5-year period.
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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.