Guideline: antibacterial prophylaxis in paediatric recipients of HSCT


  • Dawn O'Shea
  • Univadis Medical News
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A new clinical practice guideline (CPG) for systemic antibacterial prophylaxis administration in paediatric cancer patients and haematopoietic stem cell transplantation (HSCT) patients has been published in the journal Clinical Infectious Diseases.

Based on a systematic review of 114 randomised trials of antibiotic prophylaxis, an international, multidisciplinary expert panel has made the following recommendations:

  1. Consider systemic antibacterial prophylaxis (SAP) administration in children with acute myeloid leukaemia (AML) and relapsed acute lymphoblastic leukaemia (ALL) receiving intensive chemotherapy expected to result in severe neutropenia (absolute neutrophil count
  2. Do not use systemic antibacterial prophylaxis for children whose therapy is not expected to result in severe neutropenia for ≥7 days (strong recommendation, moderate-quality evidence).
  3. SAP should not be used routinely for children receiving induction chemotherapy for newly diagnosed ALL (weak recommendation, low-quality evidence).
  4. SAP should not be used routinely for children undergoing autologous HSCT (weak recommendation, moderate-quality of evidence).
  5. SAP should not be used routinely for children undergoing allogeneic HSCT (weak recommendation, moderate-quality of evidence).
  6. Levofloxacin is the preferred agent for SAP (strong recommendation, moderate-quality evidence).
  7. Administration should be restricted to the expected period of severe neutropenia (weak recommendation, low-quality evidence).