4.2 Article

Stopping antibacterial prophylaxis in pediatric allogeneic hematopoietic cell transplantation: An internal audit

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Summary: This study found that pediatric allo-HCT patients often receive prolonged courses of broad-spectrum antibiotics, despite a low frequency of fever and bacterial infections. This finding provides opportunities for interventions to improve outcomes for HCT patients.

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Clostridioides difficile infection in paediatric patients with cancer and haematopoietic stem cell transplant recipients

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Summary: This study aimed to describe the prevalence and clinical features of Clostridioides difficile infection (CDI) in pediatric patients receiving cancer treatments, propose a definition of severe CDI, and determine risk factors for CDI outcomes. The study found that the clinical cure rate was 82.9% and recurrence rate was 9.6%. Initial oral vancomycin was significantly associated with a reduction in repeated new CDI episodes.

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Effectiveness of Quinolone Prophylaxis in Pediatric Acute Leukemia and Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-analysis

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Summary: The effectiveness of quinolone prophylaxis in high-risk hematological pediatric patients is controversial. This systematic review found that quinolone prophylaxis can reduce the incidence of bloodstream infections and neutropenic fever in pediatric acute leukemia patients, but it had no significant effect in HSCT recipients.

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Antibiotic Resistant Bloodstream Infections in Pediatric Patients Receiving Chemotherapy or Hematopoietic Stem Cell Transplant: Factors Associated with Development of Resistance, Intensive Care Admission and Mortality

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Summary: Bloodstream infections (BSI) caused by resistant Gram-negatives in children receiving antineoplastic chemotherapy or HSCT have high occurrence rates, with previous exposure to antibiotics or colonization of resistant pathogens being possible causes. Resistant Gram-negatives are significantly associated with ICU admission and mortality, with treating centers playing an important role in the outcome of treatment. The evidence of significant center-level variations on AR, ICU admission, and mortality emphasizes the need for careful local antibiotic stewardship and infection control programs.

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Summary: The efficacy between levofloxacin and ciprofloxacin prophylaxis in pediatric recipients undergoing allogeneic hematopoietic stem cell transplantation for hematological malignancies is similar, but levofloxacin prophylaxis is associated with significantly lower cumulative antibiotic exposure.

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Supportive Care During Pediatric Hematopoietic Stem Cell Transplantation: Prevention of Infections. A Report From Workshops on Supportive Care of the Paediatric Diseases Working Party (PDWP) of the European Society for Blood and Marrow Transplantation (EBMT)

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Summary: The lack of detailed supportive care protocols in international HSCT guidelines, especially regarding infection prophylaxis and daily life restrictions post-transplant, has led the Pediatric Diseases Working Party of the EBMT to initiate the development of minimal recommendations through dedicated workshops since 2017.

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Decontamination therapy in allo-HCT

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