Background: Febrile neutropenia (FN) is a common and potentially life-threatening complication in pediatric oncology. Rapid initiation of empiric antibiotics is critical to improving prognosis. This study evaluated the impact of simple changes to a standard operating procedure (SOP) for FN treatment on the time-to-antibiotic (TTA) in pediatric cancer patients, as well as potential clinical effects.Methods: In this retrospective, single-center, cohort study, children with cancer presenting with FN at the emergency room (pedER) or oncology outpatient department (OD) were included over two one-year periods—before and after SOP adaption. The revised SOP defined a target TTA of ≤30 min. The primary endpoint was to compare median TTA and the proportion of FN episodes meeting target TTA. Secondary endpoints comprised adverse events (AEs) (e.g., ICU admission, need for respiratory or circulatory support, sepsis criteria).Results: After SOP adaption, 32.9% of episodes met target TTA, up from 5.9% before. Median TTA was significantly reduced (44 min vs. 93 min). The improvement persisted during the study period. AE rates showed no significant change.Conclusions: Simple procedural adjustments may significantly improve quality indicators of care, e.g., reducing TTA in pediatric FN patients. These adjustments may be transferable to other pediatric oncology settings.
背景：发热性中性粒细胞减少症（FN）是儿科肿瘤学中常见且可能危及生命的并发症。快速启动经验性抗生素治疗对改善预后至关重要。本研究评估了FN治疗标准操作规程（SOP）的简单调整对儿科癌症患者抗生素使用时间（TTA）的影响及其潜在的临床效应。 方法：在这项回顾性、单中心队列研究中，纳入了在急诊科（儿科急诊）或肿瘤科门诊就诊的癌症伴FN患儿，研究覆盖SOP调整前后各一年的两个时间段。修订后的SOP将目标TTA设定为≤30分钟。主要终点是比较中位TTA及达到目标TTA的FN发作比例。次要终点包括不良事件（如入住ICU、需要呼吸或循环支持、符合脓毒症标准）。 结果：SOP调整后，达到目标TTA的发作比例从之前的5.9%上升至32.9%。中位TTA显著缩短（44分钟 vs. 93分钟）。这种改善在研究期间持续存在。不良事件发生率未见显著变化。 结论：简单的流程调整可显著改善医疗质量指标，例如缩短儿科FN患者的TTA。这些调整或可推广至其他儿科肿瘤诊疗场景。
肿瘤(癌症)患者之家