Differences in infection prophylaxis measures between paediatric acute myeloid leukaemia study groups within the...

Area of Science:

• Paediatric Haematology
• Infectious Diseases
• Oncology

Background:

• Infection prevention is critical for paediatric patients with acute myeloid leukaemia (AML).
• Current infection prophylaxis recommendations are often non-specific and lack high-quality evidence.
• This leads to divergent preventive regimens across different study groups and hospitals.

Purpose of the Study:

• To investigate and compare infection prophylaxis guidelines within paediatric AML study groups.
• To evaluate differences in daily practice among hospitals regarding infection prevention.
• To establish a baseline for future studies on infection prophylaxis guidelines in paediatric AML.

Main Methods:

• A web-based survey was distributed to 22 paediatric AML study groups affiliated with the international Berlin-Frankfürt-Münster study group.
• A modified survey was administered to 27 representatives from the Nordic Society for Paediatric Haematology and Oncology-Dutch-Belgium-Hong Kong - AML study group to assess hospital practices.
• Data on antibiotic prophylaxis (gram-negative and gram-positive), antifungal agents, and social/food restrictions were collected.

Main Results:

• Only 32% of study groups recommend gram-negative antibiotic prophylaxis, primarily fluoroquinolones.
• 36% of groups prescribe gram-positive prophylaxis.
• Over 60% of groups recommend food and social restrictions, with significant variation in specifics and strictness.
• Hospital practices showed substantial differences in gram-negative antibiotic use, prophylactic antifungal agents, and restriction strictness, despite general adherence to study group guidelines.

Conclusions:

• Significant heterogeneity exists in infection prophylaxis strategies among paediatric AML study groups and affiliated hospitals.
• Variations in antibiotic prophylaxis, antifungal use, and social restrictions persist despite collaborative efforts.
• The findings underscore the need for standardized, evidence-based guidelines to optimize infection prevention in paediatric AML patients.