Most Read Articles
Pearl Toh, 3 days ago
Not only does the CGRP* inhibitor galcanezumab show sustained efficacy in migraine patients, long-term treatment does not come with excess cardiovascular (CV) risk, according to studies presented at the AAN 2021 Annual Meeting.
01 Apr 2021
Migraine and headache are common ailments of people living in the modern era. Dr Jon Marshall of The Singapore Headache and Migraine Clinic shares his insights with Pearl Toh on how to manage migraine and headache using non-pharmaceutical strategies, with a focus on the manual medicine approach.
Tristan Manalac, 5 days ago
Visceral fat area is the strongest indicator of mobility disability among obese, community-dwelling, older adults, according to a recent Singapore study.
3 days ago
In a webinar held on 27 March 2021, paediatric endocrinology nurses Karen Blair, Kate Davies, and Siti Zarina Yaakop shared insights and clinical experience based on their frontline roles in caring for patients with central precocious puberty (CPP) and supporting their family members.

Ceftriaxone fails to impress in non-neutropenic fever in children with cancer

5 days ago

Nearly half of non-neutropaenic fever episodes in children with cancer are associated with respiratory symptoms, according to a recent study. Of note, ceftriaxone monotherapy has a high failure rate in these patients.

The authors retrospectively analysed the efficacy of the current clinical approach for management of non-neutropaenic fever episodes and the associated risk factors among children with cancer at the Princess Noorah Oncology Center in Jeddah, Saudi Arabia, from May 2016 through December 2017.

Overall, 480 non-neutropaenic fever episodes occurred in 131 children, of which 62 episodes were triaged as high-risk and 418 as low-risk non-neutropaenic fever. In addition, 361 (75.2 percent) of the 480 episodes correlated with the presence of central venous catheters.

The overall failure rate of ceftriaxone monotherapy stood at 75.6 percent: 11.7 percent in high-risk non-neutropaenic fever with a mean C-reactive protein (CRP) level of 21.1 mmol/L and 63.9 percent in low-risk non-neutropaenic fever with a mean CRP level of 17.6 mmol/L.

For bacteraemia, the overall rate was 14.4 percent. The type of organisms was primarily high-risk in 59 non-neutropaenic fever episodes (85.5 percent; odds ratio [OR], 1.78, 95 percent confidence interval [CI], 0.45–7.04; p=0.41). Notably, all bacteraemia (100 percent) correlated with the presence of central venous catheter.

The only risk factor of outpatient treatment failure in low-risk non-neutropaenic fever that was significantly associated with bacteraemia was prolonged fever of more than 3 days (OR, 8.107, 95 percent CI, 1.744–37.691; p=0.008). In addition, about 43 percent of non-neutropaenic fever episodes were associated with respiratory symptoms.

“This study provides a baseline for future prospective research assessing the pattern of non-neutropenic fever by focusing on associated risk factors,” the authors said.

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Most Read Articles
Pearl Toh, 3 days ago
Not only does the CGRP* inhibitor galcanezumab show sustained efficacy in migraine patients, long-term treatment does not come with excess cardiovascular (CV) risk, according to studies presented at the AAN 2021 Annual Meeting.
01 Apr 2021
Migraine and headache are common ailments of people living in the modern era. Dr Jon Marshall of The Singapore Headache and Migraine Clinic shares his insights with Pearl Toh on how to manage migraine and headache using non-pharmaceutical strategies, with a focus on the manual medicine approach.
Tristan Manalac, 5 days ago
Visceral fat area is the strongest indicator of mobility disability among obese, community-dwelling, older adults, according to a recent Singapore study.
3 days ago
In a webinar held on 27 March 2021, paediatric endocrinology nurses Karen Blair, Kate Davies, and Siti Zarina Yaakop shared insights and clinical experience based on their frontline roles in caring for patients with central precocious puberty (CPP) and supporting their family members.