Adverse effects of antibiotics in children with cancer: are short-course antibiotics for febrile neutropenia part of the solution?

被引：4
作者：
Butters, Coen [1 ,2 ,3 ]
Thursky, Karin [4 ,5 ,6 ]
Hanna, Diane T. [7 ]
Cole, Theresa [2 ,3 ,8 ]
Davidson, Andrew [3 ,9 ,10 ,11 ,12 ]
Buttery, Jim [3 ,11 ,13 ,14 ]
Haeusler, Gabrielle [2 ,3 ,4 ,5 ,11 ]
机构：
[1] John Hunter Childrens Hosp, Dept Gen Paediat & Adolescent Med, Newcastle, Australia
[2] Murdoch Childrens Res Inst, Infect & Immun, Parkville, Australia
[3] Univ Melbourne, Dept Paediat, Parkville, Australia
[4] Peter MacCallum Canc Ctr, Dept Infect Dis, Parkville, Australia
[5] Univ Melbourne, Natl Ctr Antimicrobial Stewardship, Dept Infect Dis, Parkville, Australia
[6] Univ Melbourne, Dept Med, Parkville, Australia
[7] Royal Childrens Hosp, Childrens Canc Ctr, Parkville, Australia
[8] Royal Childrens Hosp, Allergy & Immunol, Parkville, Australia
[9] Royal Childrens Hosp, Dept Anaesthesia, Parkville, Australia
[10] Univ Melbourne, SAEFVIC, Parkville, Australia
[11] Royal Childrens Hosp, Infect Dis Unit, Parkville, Australia
[12] Murdoch Childrens Res Inst, Melbourne Childrens Trials Ctr, Parkville, Australia
[13] Melbourne Childrens Campus, Ctr Hlth Analyt, Parkville, Australia
[14] Murdoch Childrens Res Inst, Hlth Informat Grp, Parkville, Australia
来源：
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY | 2023年 / 21卷 / 03期
关键词：
pediatric; febrile neutropenia; microbiome; hematopoietic stem cell transplant; acute leukemia; antimicrobial resistance; graft-versus-host disease; CLOSTRIDIUM-DIFFICILE INFECTION; STEM-CELL TRANSPLANTATION; VERSUS-HOST-DISEASE; PEDIATRIC ONCOLOGY PATIENTS; RISK-FACTORS; INTESTINAL MICROBIOTA; ANTIMICROBIAL THERAPY; CLINICAL-OUTCOMES; BACTEREMIA; RECIPIENTS;
D O I：
10.1080/14787210.2023.2171987
中图分类号：
R51 [传染病];
学科分类号：
100401 ;
摘要：
IntroductionFebrile neutropenia is a common complication experienced by children with cancer or those undergoing hematopoietic stem cell transplantation. Repeated episodes of febrile neutropenia result in cumulative exposure to broad-spectrum antibiotics with potential for a range of serious adverse effects. Short-course antibiotics, even in patients with high-risk febrile neutropenia, may offer a solution.Areas coveredThis review addresses the known broad effects of antibiotics, highlights developments in understanding the relationship between cancer, antibiotics, and the gut microbiome, and discusses emerging evidence regarding long-term adverse antibiotic effects. The authors consider available evidence to guide the duration of empiric antibiotics in pediatric febrile neutropenia and directions for future research.Expert opinionBroad-spectrum antibiotics are associated with antimicrobial resistance, Clostridioides difficile infection, invasive candidiasis, significant disturbance of the gut microbiome and may seriously impact outcomes in children with cancer or undergoing allogenic hematopoietic stem cell transplant. Short-course empiric antibiotics are likely safe in most children with febrile neutropenia and present a valuable opportunity to reduce the risks of antibiotic exposure.
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收藏
页码：267 / 279
页数：13
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