{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:27:43Z","timestamp":1787761663923,"version":"build-2784847793"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>While clinical practice guidelines (CPGs) for pediatric oncology infection prophylaxis and management exist, few data describe actual management occurring at pediatric oncology centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An electronic survey querying infection management practices in nontransplant pediatric oncology patients was iteratively created by the Children's Oncology Group (COG) Cancer Control and Supportive Care Infectious Diseases Subcommittee and sent to leaders at all COG institutions, limiting each site to one response to represent their institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The response rate was 57% (129\/227 institutions). Many sites reported utilizing COG\u2010endorsed CPGs for antibacterial (76%) and antifungal prophylaxis (74%), and fever and neutropenia (FN, 64%). Most institutions reported using antimicrobial prophylaxis for patients with acute myeloid leukemia (88% antibacterial, 100% antifungal) and relapsed acute lymphoblastic leukemia (82% antibacterial, 95% antifungal). Definitions of fever, phagocyte recovery, and antibiotic duration in febrile patients varied. Most institutions administer empiric broad\u2010spectrum antibiotics for nonneutropenic fever, although 14% reported withholding antibiotics based on initial clinical status or risk stratification tools. Most respondents reported (70%) admitting FN patients for at least 48 h, however 15% have low\u2010risk FN protocols allowing outpatient management. FN patients remain admitted on antibiotics through count recovery in 50% of institutions, whereas the others employed various early discharge\/early antibiotic discontinuation strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is often consistency but also substantial variability in reported antimicrobial prophylaxis strategies and management of patients with fever and represents an opportunity for implementation studies to standardize application of CPG recommendations and randomized trials to advance evidence where knowledge gaps exist.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.31532","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:40:10Z","timestamp":1736383210000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Prevention and Management of Infectious Complications in Pediatric Patients With Cancer: A Survey Assessment of Current Practices Across Children's Oncology Group Institutions"],"prefix":"10.1002","volume":"72","author":[{"given":"Leonora R.","family":"Slatnick","sequence":"first","affiliation":[{"name":"Department of Pediatrics Primary Children's Hospital  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hoogstra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Helen Devos Children's Hospital  Grand Rapids Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian T.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Division of Oncology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Wolf","sequence":"additional","affiliation":[{"name":"Departments of Infectious Diseases and Pediatrics St Jude Children's Research Hospital University of Tennessee Health Science Center  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1487-6818","authenticated-orcid":false,"given":"Etan","family":"Orgel","sequence":"additional","affiliation":[{"name":"Cancer and Blood Disease Institute Children's Hospital of Los Angeles Keck School of Medicine, University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7119-1658","authenticated-orcid":false,"given":"C. 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Lee","family":"Dupuis","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Leslie Dan Faculty of Pharmacy, University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Goode","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology Children's Hospital of Michigan  Detroit Michigan USA"},{"name":"Department of Pediatrics Central Michigan University College of Medicine  Mount Pleasant Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasey","family":"Jackson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology Cook Children's Hospital  Fort Worth Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel N.","family":"Willis","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology Department of Pediatrics, Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2474-3031","authenticated-orcid":false,"given":"Caitlin","family":"Elgarten","sequence":"additional","affiliation":[{"name":"Division of Oncology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9775-2839","authenticated-orcid":false,"given":"Catherine","family":"Aftandilian","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology Stem Cell Transplant and Regenerative Medicine, Stanford University  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9609-7606","authenticated-orcid":false,"given":"Joel","family":"Thompson","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology\/BMT Department of Pediatrics Children's Mercy Hospital  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9695-1702","authenticated-orcid":false,"given":"Sarah","family":"Alexander","sequence":"additional","affiliation":[{"name":"Division of Haematology\/Oncology The Hospital for Sick Children  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4058-1586","authenticated-orcid":false,"given":"Melissa P.","family":"Beauchemin","sequence":"additional","affiliation":[{"name":"Columbia University\/Herbert Irving Cancer Center Columbia University School of Nursing  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2260-0395","authenticated-orcid":false,"given":"Jennifer A.","family":"Belsky","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology Department of Pediatrics, Riley Hospital for Children at IU Health Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Hess","sequence":"additional","affiliation":[{"name":"Children's Hospital of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3789-1121","authenticated-orcid":false,"given":"Zachary D.","family":"Prudowsky","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology, Department of Pediatrics, Baylor College of Medicine Texas Children's Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terri","family":"Guinipero","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology and Oncology Department of Pediatrics, Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0471-9883","authenticated-orcid":false,"given":"Jenna","family":"Rossoff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Hematology, Oncology and Stem Cell Transplantation, Ann &amp; Robert H. 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