• Pediatric emergency care · Jan 2022

    Time to Antibiotic for Pediatric Oncology Patients With Febrile Neutropenia at Regional Emergency Departments.

    • Aman Wadhwa, Jamie Oakley, Joshua Richman, Smita Bhatia, and Matthew A Kutny.
    • Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL.
    • Pediatr Emerg Care. 2022 Jan 1; 38 (1): e94e99e94-e99.

    ObjectivesWe compared the time to antibiotic (TTA) for pediatric oncology patients with febrile neutropenia (FN) presenting at regional emergency departments (EDs) with those presenting at a pediatric referral ED, and examined its association with need for aggressive medical care.MethodsWe abstracted data for pediatric oncology patients (age, <21 years) admitted for FN between August 2012 and August 2017 at a single children's hospital and compared the TTA between those referred from a regional ED across the state and those admitted via the referral ED at the children's hospital. Factors associated with delay in antibiotic administration (TTA, >60 minutes) were estimated using generalized linear modeling with generalized estimating equations (GEEs). Delay in antibiotic administration was examined for its association with the need for aggressive medical care (>1 fluid bolus, intensive care unit admission, inotropic or invasive ventilator support) within 24 hours of admission as an exploratory aim.ResultsThree-hundred eighty-nine FN admissions (regional ED, 26.7%; referral ED, 73.3%) occurred in 205 eligible patients. Median TTA was significantly (P < 0.0001) greater among patients presenting at a regional ED (117.5 minutes [range, 9-722 minutes]) vs referral ED (46 minutes [range, 6-378 minutes]). Presentation at regional ED was the only factor associated with delay in antibiotic administration (odds ratio, 9.73; 95% confidence interval, 5.37-17.63; P < 0.0001). Delay in antibiotic administration was not associated with greater need for aggressive medical care (odds ratio, 1.34; 95% confidence interval, 0.55-3.29; P = 0.5).ConclusionsPediatric oncology patients with FN presenting to regional EDs have longer TTA as compared with those presenting to a referral ED at a children's hospital.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…