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•स्क्रिनमा देखिने चुरोट: सुर्तीजन्य हानि न्यूनीकरण नीतिमा दक्षिण एसियाले अझै के छुटाइरहेको छ•नेपालमा पिसाब नलीको संक्रमण र एन्टिबायोटिक प्रतिरोधको बढ्दो संकट•Frontline Perspectives on Nursing Leadership in Nepal•Protecting the Smallest Lungs from the Hidden Grip of RSV in Kathmandu•The Heavy Burden of Bullying on Student Wellbeing in Nepal•The Emerging Landscape of Thyroid Health in Central Nepal•How a Recent Western Nepal Study is Redefining Anemia Diagnosis•How H. Pylori is Impacting the Health of Karnali’s High-Altitude Communities•Sweet Poison, Bitter Reality: The Unseen Diabetes Epidemic Among Nepal’s Youth•How Missing Checklists and Protocols are Costing Lives in Nepal’s ERs•स्क्रिनमा देखिने चुरोट: सुर्तीजन्य हानि न्यूनीकरण नीतिमा दक्षिण एसियाले अझै के छुटाइरहेको छ•नेपालमा पिसाब नलीको संक्रमण र एन्टिबायोटिक प्रतिरोधको बढ्दो संकट•Frontline Perspectives on Nursing Leadership in Nepal•Protecting the Smallest Lungs from the Hidden Grip of RSV in Kathmandu•The Heavy Burden of Bullying on Student Wellbeing in Nepal•The Emerging Landscape of Thyroid Health in Central Nepal•How a Recent Western Nepal Study is Redefining Anemia Diagnosis•How H. Pylori is Impacting the Health of Karnali’s High-Altitude Communities•Sweet Poison, Bitter Reality: The Unseen Diabetes Epidemic Among Nepal’s Youth•How Missing Checklists and Protocols are Costing Lives in Nepal’s ERs

Clinical Practice Guideline for Systemic Antibacterial and Antifungal Prophylaxis in Pediatric Patients With Cancer and Hematopoietic Cell Transplant Recipients: 2026 Update.

Researchers

Jessica E Morgan, Priya Patel, Joshua Wolf, Nadja Hawwa Vissing, Wim J E Tissing, María Elena Santolaya, Paula D Robinson, Robert Phillips, Thomas Lehrnbecher, Christa Koenig, Gabrielle M Haeusler, Andreas H Groll, Brian T Fisher, Caitlin W Elgarten, Bonnie L Davis, Yin Ting Cheung, Elio Castagnola, Fabianne Carlesse, Melissa P Beauchemin, Roland A Ammann, Sarah Alexander, L Lee Dupuis, Lillian Sung

Abstract

To provide updated Pediatric Oncology Group of Ontario clinical practice guidelines (CPGs) for systemic antibacterial and antifungal prophylaxis in pediatric patients with cancer and hematopoietic cell transplantation (HCT) recipients. In this update, we harmonized procedures and recommendations across both the antibacterial and antifungal CPGs. Systematic reviews of randomized clinical trials evaluating systemic antibacterial and antifungal prophylaxis in pediatric and adult patients with cancer and HCT recipients were updated. Using the Grading of Recommendations Assessment, Development and Evaluation approach, an international multidisciplinary panel revised or formulated recommendations and classified evidence quality. Good practice statements were also created. The updated search identified 13 new randomized trials published since 2019 (eight antibacterial and five antifungal), resulting in 195 total trials. The panel maintained a conditional recommendation to consider antibacterial prophylaxis in pediatric patients with AML and relapsed ALL and a strong recommendation to use levofloxacin when antibacterial prophylaxis is planned. A new conditional recommendation was introduced to consider using no antibacterial prophylaxis in patients unable to receive levofloxacin. Strong recommendations to use antifungal prophylaxis in pediatric patients with AML and allogeneic HCT recipients and to use an echinocandin or a mold-active azole when antifungal prophylaxis is planned were maintained. Three new good practice statements were added, focusing on drug interactions, infection prevention practices, and monitoring infection epidemiology. This update consolidates and harmonizes CPGs for systemic antibacterial and antifungal prophylaxis in pediatric patients with cancer and HCT patients. Future research should refine prophylaxis indications for different patient subgroups.
Source: PubMed (PMID: 42826360)View Original on PubMed