Overcoming challenges to reduce time to antibiotic therapy in febrile neutropenic children: insights from a Mexican center

Providing quality supportive therapy for children with cancer is essential to reduce the high mortality rates in low- and middle-income countries. Febrile neutropenia is the most common life-threatening complication of cancer in children. The objective of this study was to evaluate the long-term eff...

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Published in:Hematology, Transfusion and Cell Therapy Transfusion and Cell Therapy, 2024-12, Vol.46 Suppl 6 (Suppl 6), p.S193-S201
Main Authors: Colunga-Pedraza, Julia Esther, Lopez-Reyna, Ingrid Gabriela, Vaquera-Aparicio, Denisse Natalie, Peña-Lozano, Samantha Paulina, Arrieta, Jafet, Hernández-Torres, Lucía Elizabeth, Colunga-Pedraza, Perla Rocío, Regalado, Mónica, Jiménez-Antolinez, Yajaira Valentine, García-Rodríguez, Fernando, González-Llano, Oscar
Format: Article
Language:English
Subjects:
Febrile neutropenia
Golden hour
Hematology–oncology
Low-middle-income country
Original
Pediatrics
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Summary:Providing quality supportive therapy for children with cancer is essential to reduce the high mortality rates in low- and middle-income countries. Febrile neutropenia is the most common life-threatening complication of cancer in children. The objective of this study was to evaluate the long-term effectiveness of the 'Golden Hour' intervention in reducing the time to administer antibiotics and its impact on clinical outcomes in a Mexican hospital. A comparative study of children with febrile neutropenia who attended the emergency department at the Hospital Universitario "Dr. José Eleuterio González" was performed between January 2017 and December 2022. In May 2019, this center joined the collaborative 'Mexico in Alliance with St. Jude' project. An adapted improvement program was developed based on the implementation of an algorithm comprising institutional guidance, supplies kit, standardization of sample processing, training of healthcare providers, and patient education. The time to antibiotic administration was compared with clinical outcomes between the historical control and post-intervention groups. A total of 291 patients were included, 122 in the pre-intervention period and 169 in the intervention period. Only 5.7 % of the pre-intervention group received the first dose of antibiotics within 60 min of presenting to the emergency department compared to 84.6 % in the intervention group (p-value
ISSN:2531-1387
2531-1379
2531-1387
DOI:10.1016/j.htct.2024.04.123