Oral versus intravenous antibiotics in treatment of paediatric febrile neutropenia
Article first published online: 2 DEC 2011
© 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 49, Issue 3, pages 170–178, March 2013
How to Cite
Vedi, A. and Cohn, R. (2013), Oral versus intravenous antibiotics in treatment of paediatric febrile neutropenia. Journal of Paediatrics and Child Health, 49: 170–178. doi: 10.1111/j.1440-1754.2011.02201.x
- Issue published online: 10 MAR 2013
- Article first published online: 2 DEC 2011
- Accepted for publication 6 July 2011.
- administration oral;
- anti-bacterial agents;
The purpose of this study is to determine whether, in low-risk febrile neutropenic paediatric populations, oral antibiotics are as effective as intravenous antibiotics in obtaining resolution of the febrile neutropenic episode. A comprehensive literature search of MEDLINE, EMBASE and CENTRAL identified prospective, randomised controlled trials comparing oral antibiotics with intravenous antibiotics in the treatment of febrile neutropenic episodes in low-risk paediatric oncology patients. Outcomes assessed were mortality, rate of treatment failure, length of the febrile neutropenic episode and adverse events. The random effects model was used to calculate risk ratios (RRs) for dichotomous data and mean difference with standard deviation for continuous data. Seven trials were included in the overall analysis, which included 934 episodes of febrile neutropenia in 676 patients aged between 9 months and 20 years. The overall treatment failure rates were not significantly different between oral and intravenous antibiotics (RR: 1.02, 95% confidence interval 0.78–1.32, P= 0.91). In carefully selected low-risk febrile neutropenic children, empiric treatment with oral antibiotics is a safe and effective alternative to intravenous antibiotics as they lower the cost of treatment as well as psychosocial burden on these children and their families.