{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T11:58:13Z","timestamp":1781179093265,"version":"3.54.1"},"reference-count":31,"publisher":"Scientific Scholar","issue":"04","license":[{"start":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T00:00:00Z","timestamp":1662076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["South Asian J Cancer"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:p>Background\u2003To enable outpatient department (OPD) management of febrile neutropenia (FN), we used once-a-day (OD) ceftriaxone\u2013amikacin (CFT-AMK) as empiric antibiotic therapy. Our experience over 16-year period is presented.<\/jats:p>\n                  <jats:p>Methods\u2003This was a retrospective study conducted from January2002 to December2017. Inclusion criteria were &lt;18 years of age, undergoing cancer chemotherapy, and having FN. Exclusion criteria were FN after palliative chemotherapy, bone marrow transplantation, or at diagnosis of malignancy. Empiric CFT-AMK was used in all, except those having respiratory distress, hypotension, altered sensorium, paralytic ileus, or clinical evidence of peritonitis. Admission criteria were age &lt;1 year, acute myeloid leukemia (AML) chemotherapy, poor performance status, need for blood transfusions, convenience, insurance, or persistent fever &gt;48 to 72\u2009hours after CFT-AMK. Outcomes analyzed were response (defervescence within 48\u201372\u2009hours), OPD management, antibiotic upgrade, and mortality. AML diagnosis, &gt;7 days to absolute neutrophil count &gt;0.5\u2009\u00d7\u2009109\/L, poor performance status, and malignancy not in remission were considered high-risk FN criteria.<\/jats:p>\n                  <jats:p>Results\u2003CFT-AMK was given in 877\/952 (92.2%) FN episodes. Seventy-six percent had hematolymphoid malignancies. Response, antibiotic upgrade, and mortality were seen in 85.7 and 65.5% (p\u2009&lt;\u20090.0001), 15 and 45.5% (p\u2009&lt;\u20090.0001), and 0 and 2% (p\u2009=\u20090.003) of low- and high-risk patients, respectively. Treatment was started in OPD in 52%, of which 21.6% required subsequent admission. Of those initially admitted, early discharge (hospital stay\u2009&lt;\u20095 days) was possible in 24.6%. Forty-one percent episodes were managed entirely on OPD. Overall, 80% of low-risk and 42% of high-risk episodes received treatment wholly or partially on OPD.<\/jats:p>\n                  <jats:p>Conclusion\u2003Our results show empiric OD CFT-AMK allows OPD management for most of the low-risk and a proportion of high-risk FN following chemotherapy in children, without compromising clinical outcomes.<\/jats:p>","DOI":"10.1055\/s-0042-1745834","type":"journal-article","created":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T18:56:27Z","timestamp":1662144987000},"page":"370-377","source":"Crossref","is-referenced-by-count":1,"title":["Once-a-Day Ceftriaxone\u2013Amikacin Combination as Empiric Antibiotic Therapy to Enable Outpatient Management of Febrile Neutropenia in Children\u201416-Year Experience from a Single Institute"],"prefix":"10.25259","volume":"11","author":[{"given":"Shailesh","family":"Kanvinde","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Mulay","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Clinical Epidemiology, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Deshpande","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chetan","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sampada","family":"Patwardhan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Deenanath Mangeshkar Hospital, Pune, Maharashtra, 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