While febrile neutropenia remains a prevalent complication among children undergoing cancer treatment, optimizing its management is crucial for enhancing patient outcomes and reducing healthcare expenses. A recent study conducted by the National Cancer Institute (NCI) offers valuable insights into the effectiveness of different oral antibiotic regimens for low-risk (LR) FN in pediatric patients.
Study Design and Methodology
Between December 2021 and September 2022, the NCI executed a randomized controlled trial involving children and adolescents aged 3 to 18 years. The study excluded participants under three years old and those with Down syndrome, focusing on 200 LR-FN episodes evenly split between two treatment groups. Data on patient demographics, microbiological profiles, and treatment outcomes were meticulously gathered over a seven-day period. A decision analytic model assessed the quality-adjusted FN episodes, costs, and incremental cost-effectiveness ratios of oral levofloxacin compared to oral amoxicillin-clavulanate/ciprofloxacin.
Key Findings and Implications
- Levofloxacin demonstrated safety and effectiveness comparable to traditional antibiotic treatments.
- The antibiotic reduced costs by approximately 62.5 Egyptian pounds while providing a slight increase in quality-adjusted life-years (QALY) of 0.0001.
- These results fell well within the willingness-to-pay threshold of 77,520 EGPs per QALY, highlighting its economic viability.
Levofloxacin proved to be the dominant strategy over amoxicillin-clavulanate/ciprofloxacin, presenting a practical and economical solution for managing home-based LR-FN in pediatric cancer patients within a one-week timeframe from the NCI’s perspective.
The adoption of levofloxacin could streamline resource allocation within healthcare systems, ensuring that supportive care for children with low-risk FN becomes both more effective and financially sustainable. As pediatric oncology continues to evolve, integrating such evidence-based antibiotic strategies will be vital in improving patient care standards and achieving cost-efficiency.
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