SHM Converge Scientific Abstract ePoster Gallery-Combating Antibiotic Resistance: Rethinking Fever Management in Newly Diagnosed Pediatric Acute Lymphoblastic Leukemia

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This study examines whether fever in children newly diagnosed with acute lymphoblastic leukemia (ALL) is usually caused by infection or by the leukemia itself, and whether routine broad-spectrum antibiotics are necessary. Because antimicrobial resistance is worsened by antibiotic overuse, the authors looked at fever management in pediatric ALL patients at Children’s Hospital Los Angeles.<br /><br />In this retrospective cohort study, 30 patients under age 18 with a new leukemia diagnosis and fever during initial hospitalization were analyzed. Researchers reviewed fever patterns, antibiotic use, microbiology results, imaging, and fever resolution after both antibiotics and anti-leukemic treatment.<br /><br />Key findings showed that although 63% of patients had documented fever, 92.8% received broad-spectrum antibiotics, and 30% were given antibiotics without a recorded fever. Microbiologic testing found no positive blood, urine, or sputum cultures. Only two patients had possible clinical infections. Fever persisted after antibiotics in 89.5% of patients, but only 26.3% remained febrile after starting anti-leukemic therapy. Statistical analysis showed fever decreased much more after cancer treatment than after antibiotics.<br /><br />The authors conclude that fevers in newly diagnosed pediatric leukemia patients are rarely infectious and are more likely related to leukemic disease activity. Anti-leukemic therapy, not antibiotics, appears to be the main driver of fever resolution. The study suggests reconsidering routine empiric broad-spectrum antibiotic use in this group and calls for larger multi-center studies to better guide antibiotic decisions and evaluate narrower-spectrum approaches.

Asset Subtitle

Shreeti H. Patel

Meta Tag

Author List Ashima J. Sharma, Paul Gaynon, Shreeti H. Patel

Category Research

Concept Pediatric Acute Lymphoblastic Leukemia

Concept Fever

Concept Noninfectious Fever

Concept Infection

Concept Infection Prevalence

Distinguished Non-Finalist

Presenter Organization University of California, San Diego

Presenting Author Shreeti H. Patel

Track Pediatric

Keywords

pediatric acute lymphoblastic leukemia

fever

infection

broad-spectrum antibiotics

antimicrobial resistance

retrospective cohort study

Children's Hospital Los Angeles

anti-leukemic therapy

fever management

empiric antibiotic use

Pediatric Acute Lymphoblastic Leukemia

Fever

Noninfectious Fever

Infection

Infection Prevalence