INTRODUCTION: With new multidrug-resistant microbes and the paucity of new antibacterial agents, we must identify opportunities to safely minimize antibiotics. Current guidelines encourage empiric antibiotics in febrile @entity1 with chemotherapy-induced @entity1398 to reduce infection-related mortalities. No guidelines exist for @entity1 with isolated fever at presentation/diagnosis of @entity981 ( @entity981 ) and before starting chemotherapy. This study evaluates the incidence of @entity2259 in this subpopulation. MATERIALS AND METHODS: We retrospectively analyzed medical records of 230 consecutive @entity1 under 21 years of age diagnosed with @entity981 at @entity1 's Hospital _ Research Center Oakland ( @entity580 ) from January 2003 through October 2013. We focused on blood cultures obtained within 24 hours of presentation to @entity580 , which was before general anesthesia for a procedure or systemic chemotherapy. RESULTS: Among 221 @entity1 who met the inclusion criteria, 126 (57%) were febrile and had blood cultures obtained. Two @entity1 (1.6%) had positive blood cultures consistent with @entity2259 ; 1 had group A b-hemolytic streptococcus and the other had @entity526 . DISCUSSION: Given the rarity of @entity2259 in this subpopulation at our institution, we recommend more judicious use of antibiotics in @entity1 with isolated fever at time of @entity981 diagnosis. We encourage other institutions to conduct similar investigations.

Fever at Diagnosis of XXXX : Are Antibiotics Really Necessary?

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'Children'] @entity981 :: ('MESH:D054198', 'Disease') :: ['ALL', 'acute lymphoblastic leukemia'] @entity1398 :: ('MESH:D009503', 'Disease') :: ['neutropenia'] @entity580 :: ('MESH:D003428', 'Disease') :: ['CHRCO'] @entity2259 :: ('MESH:D016470', 'Disease') :: ['bacteremia'] @entity526 :: ('562', 'Species') :: ['Escherichia coli']
@entity981 :: (MESH:D054198,Disease) :: ['Pediatric Acute Lymphoblastic Leukemia']
