Evidence map›Paper›PMID 36600323›Full record

ArticleArchives of disease in childhood2023

Can I go home now? The safety and efficacy of a new UK paediatric febrile neutropenia protocol for risk-stratified early discharge on oral antibiotics.

Thomas John Jackson, Rachel Napper, Gabrielle M Haeusler, Barry Pizer, Jessica Bate, Richard G Grundy, Sujith Samarasinghe, Paola Angelini, Ashley Ball-Gamble, Bob Phillips and 1 more

Erratum issuedAbstract read
In one paragraph

Article in Archives of disease in childhood, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Thomas John JacksonPaediatric Oncology, University College London Hospital, London, UK thomas.jackson4@nhs.net.ORCID 0000-0003-1669-6666
Rachel NapperRegional Department of Paediatric Haematology and Oncology, Leeds Children's Hospital, Leeds, UK.
Gabrielle M HaeuslerInfectious Diseases and Infection Control, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Barry PizerPaediatric Oncology, Royal Liverpool Children's Hospital, Liverpool, UK.
Jessica BatePaediatric Oncology, Southampton Children's Hospital, Southampton, UK.ORCID 0000-0003-4933-9497
Richard G GrundyChildren's Cancer Leukaemia Group Chair, University of Nottingham, Nottingham, UK.
Sujith SamarasinghePaediatric Haematology, Great Ormond Street Hospital for Children, London, UK.
Paola AngeliniChildren and Young People Unit, Royal Marsden Hospital Sutton, Sutton, UK.
Ashley Ball-GambleChildren's Cancer and Leukaemia Group, Leicester, UK.ORCID 0000-0002-0708-0918
Bob PhillipsLeeds Children's Hospital, Leeds, UK.ORCID 0000-0002-4938-9673
Jessica Elizabeth MorganLeeds Children's Hospital, Leeds, UK.ORCID 0000-0001-8087-8638

Funding

Medical Research Council G0800472
6 · The paper itself

Abstract

objectiveTo evaluate a new protocol of risk stratification and early discharge for children with febrile neutropenia (FN).

designProspective service evaluation from 17 April 2020 to 16 April 2021.

setting13 specialist centres in the UK. PATIENTS: 405 children presenting with FN.

interventionAll children received intravenous antibiotics at presentation. Risk stratification was determined using the Australian-UK-Swiss (AUS) rule and eligibility for homecare assessed using criteria including disease, chemotherapy, presenting features and social factors. Those eligible for homecare could be discharged on oral antibiotics after a period of observation proportional to their risk group.

main outcome measuresMedian duration of admission and of intravenous antibiotics, and percentage of patients with positive blood cultures, significant infection, readmission within 7 days of initial presentation, intensive care unit (ICU) admission, death from infection and death from other causes.

results13 centres contributed 729 initial presentations of 405 patients. AUS rule scores were positively correlated with positive blood cultures, significant infection, ICU admission and death. 20% of children were eligible for homecare with oral antibiotics, of which 55% were low risk (AUS 0-1). 46% low-risk homecare eligible patients were discharged by 24 hours vs 2% homecare ineligible. Homecare readmission rates were 14% overall and 16% for low-risk cases (similar to a meta-analysis of previous studies). No child eligible for homecare was admitted to ICU or died.

conclusionsUse of the AUS rule and homecare criteria allow for safe early outpatient management of children with FN.

Indexed as

Febrile NeutropeniaNeoplasmsAnti-Bacterial AgentsAustraliaChildHumansMeta-Analysis as TopicPatient DischargeProspective StudiesUnited KingdomAnti-Bacterial Agentsinfectious disease medicinepaediatrics

Identifiers

PMID36600323
PMCPMC9985710

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.