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

Butters, C; Thursky, K; Hanna, DT; Cole, T; Davidson, A; Buttery, J; Haeusler, G

Author(s): Butters, C; Thursky, K; Hanna, DT; Cole, T; Davidson, A; Buttery, J; Haeusler, G;
Details: Publication Year 2023-03,Volume 21,Issue #3,Page 267-279
Journal Title: Expert Review of Anti-Infective Therapy
Publication Type: Review
Abstract: INTRODUCTION: Febrile 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 COVERED: This 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 OPINION: Broad-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.
Publisher: Taylor & Francis
Keywords: Humans; Child; Anti-Bacterial Agents/adverse effects; *Febrile Neutropenia/drug therapy; *Neoplasms/complications/drug therapy; *Hematopoietic Stem Cell Transplantation/adverse effects; *Clostridium Infections/drug therapy; acute leukemia; antimicrobial resistance; febrile neutropenia; graft-versus-host disease; hematopoietic stem cell transplant; microbiome; pediatric
Department(s): Infectious Diseases
PubMed ID: 36694289
Publisher's Version: https://doi.org/10.1080/14787210.2023.2171987
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-04-04 06:09:38

Last Modified: 2023-04-17 11:53:04