{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T16:49:11Z","timestamp":1782060551162,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,4,14]],"date-time":"2018-04-14T00:00:00Z","timestamp":1523664000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1056158"],"award-info":[{"award-number":["GNT1056158"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Variation in the management of fever and neutropenia (FN) in children is well described. The aim of this study was to explore the current management of FN across Australia and New Zealand and highlight areas for improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A practice survey was administered to paediatric health\u2010care providers via four clinical and research networks. Using three clinical case vignettes, we explored risk stratification, empiric antibiotics, initial investigations, intravenous\u2013oral switch, ambulatory management and antibiotic duration in children with cancer and FN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A response was received from 104 participants from 16 different hospitals. FN guideline compliance was rated as moderate or poor by 24% of respondents, and seven different fever definitions were described. There was little variation in the selected empiric monotherapy and dual\u2010therapy regimens, and almost all respondents recommended first\u2010dose antibiotics within 1 h. However, 27 different empiric antibiotic combinations were selected for beta\u2010lactam allergy. An incorrect risk status was assigned to the low\u2010risk case by 27% of respondents and to the high\u2010risk case by 41%. Compared to current practice, significantly more respondents would manage the low\u2010risk case in the ambulatory setting provided adequate resources were in place (43 vs. 85%, <jats:italic>P<\/jats:italic> &lt; 0.0001). There was variation in the use of empiric glycopeptides as well as use of aminoglycosides beyond 48 h.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although the antibiotics selected for empiric management of FN are appropriate and consistent, variation and inaccuracies exist in risk stratification, the selection of monotherapy over dual therapy, empiric antibiotics chosen for beta\u2010lactam allergy, use of glycopeptides and duration of aminoglycosides.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.13899","type":"journal-article","created":{"date-parts":[[2018,4,14]],"date-time":"2018-04-14T23:15:29Z","timestamp":1523747729000},"page":"761-769","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Management of fever and neutropenia in children with cancer: A survey of Australian and New Zealand practice"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0371-8176","authenticated-orcid":false,"given":"Gabrielle M","family":"Haeusler","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre University of Melbourne  Melbourne Victoria Australia"},{"name":"NHMRC National Centre for Infections in Cancer University of Melbourne  Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Melbourne Victoria Australia"},{"name":"Paediatric Integrated Cancer Service Victoria State Government  Melbourne Victoria Australia"},{"name":"Department of Infection and Immunity Monash Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica A","family":"Slavin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre University of Melbourne  Melbourne Victoria Australia"},{"name":"NHMRC National Centre for Infections in Cancer University of Melbourne  Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Medicine University of Melbourne  Melbourne Victoria Australia"},{"name":"Victorian Infectious Diseases Service The Peter Doherty Institute for Infection and Immunity  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penelope A","family":"Bryant","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Department of Paediatrics University of Melbourne  Melbourne Victoria Australia"},{"name":"Infectious Diseases Unit Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1107-2187","authenticated-orcid":false,"given":"Franz E","family":"Babl","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Department of Paediatrics University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Emergency Medicine Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francoise","family":"Mechinaud","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute, Department of Paediatrics University of Melbourne  Melbourne Victoria Australia"},{"name":"Children's Cancer Centre Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin A","family":"Thursky","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Peter MacCallum Cancer Centre University of Melbourne  Melbourne Victoria Australia"},{"name":"NHMRC National Centre for Infections in Cancer University of Melbourne  Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Melbourne Victoria Australia"},{"name":"Department of Medicine University of Melbourne  Melbourne Victoria Australia"},{"name":"Victorian Infectious Diseases Service The Peter Doherty Institute for Infection and Immunity  Melbourne Victoria 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