Early Versus Late Stopping of Antibiotics in Children With Cancer and High-risk Febrile Neutropenia
This randomised controlled trial will determine the non-inferiority of stopping empiric antibiotics prior to absolute neutrophil count (ANC) recovery (Early Stopping) versus stopping antibiotics upon ANC recovery (Standard of Care/ Late Stopping) , in children with cancer and high-risk febrile neutropenia (FN).
• Diagnosis of
‣ Acute myeloid leukemia (AML) or acute lymphoblastic leukaemia (ALL) in dose-intensive phases of induction/re-induction, intensification or consolidation or
⁃ ALL or acute lymphoblastic lymphoma patients on a TOT17 protocol or
⁃ Any disease within 100 days of allogeneic or autologous HSCT
• Neutropenia (\<500 cells/mm3)
• Afebrile (temperature \<38.0°C) period for at least 48 hours and no more than 96 hours after at least one temperature measured by axillary or tympanic thermometer (≥38.0°C)
• Commenced on empiric FN antibiotics (any of piperacillin-tazobactam, cefepime, ceftazidime or vancomycin and ciprofloxacin)