26. Infections in pediatric and adolescent oncology

  1. Ross Pinkerton MB, BCh, BaO, MD Executive Director, Division of Oncology2,
  2. Ananth Shankar MD, FRCPCH Consultant in Paediatric and Adolescent Oncology3 and
  3. Katherine K. Matthay BA, MD Mildred V. Strouss Professor of Translational Oncology, Director, Pediatric Hematology-Oncology4
  1. Ananth Shankar and
  2. Sara Stoneham

Published Online: 8 MAY 2013

DOI: 10.1002/9781118625309.ch26

Evidence-Based Pediatric Oncology

Evidence-Based Pediatric Oncology

How to Cite

Shankar, A. and Stoneham, S. (2013) Infections in pediatric and adolescent oncology, in Evidence-Based Pediatric Oncology (eds R. Pinkerton, A. Shankar and K. K. Matthay), John Wiley & Sons, Ltd, Oxford. doi: 10.1002/9781118625309.ch26

Editor Information

  1. 2

    Royal Children's Hospital, Children's Health Queensland, Brisbane, QLD, Australia

  2. 3

    University College London Hospitals NHS Foundation Trust London, UK

  3. 4

    Department of Pediatrics, UCSF School of Medicine and, UCSF Benioff Children's Hospital, San Francisco, CA, USA

Author Information

  1. University College London Hospitals NHS Foundation Trust, London, UK

Publication History

  1. Published Online: 8 MAY 2013
  2. Published Print: 20 MAY 2013

ISBN Information

Print ISBN: 9780470659649

Online ISBN: 9781118625309

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Keywords:

  • central venous catheter (CVC);
  • febrile neutropenia;
  • fungal infection;
  • infections;
  • pathogens

Summary

An understanding of the variety of pathogens involved in rapid overwhelming sepsis is vital for informing antibiotic choices. With the increasing use of indwelling central venous catheters and thus breaches in skin integument, gram-positive isolates were increasingly recognized. It is clear, however, that the risk for dissemination of infection or complications varies with underlying disease, current illness presentation, chemotherapy regimen, degree and duration of neutrophil suppression and presence or absence of central venous catheter (CVC). The individualization of supportive care by center contrasts starkly with the collaborative approach to chemotherapy and treatment of children with cancer across developed countries. Fungal infections rarely are identified in early febrile neutropenia, but are frequently a cause of prolonged fever with neutropenia. The randomized controlled trials (RCTs) identified in this chapter provide evidence for equivalence between piptazobactam and cefozopran, piptazobactam and imipenem, piptazobactam and cefoperazone, piptazobactam and cefepime.