August 10, 2022
Healio spoke with a pair of PIDS members following the publication of their review article on pediatric enterocolitis. The authors remarked there was a dearth of current literature on managing neutropenic enterocolitis in pediatric patients with cancer and that early recognition and antibiotic treatment are key in helping children at possible risk, those receiving myelotoxic therapy for cancer or hematopoietic stem cell transplantation.
The disease has the potential to delay chemotherapy, affect nutrition, require prolonged hospitalization or surgery, and could put patients at risk of these and other potentially life-threatening complications. According to the authors in the article, the central pillars of treatment are empiric antibiotic therapy and supportive care, with surgery reserved for intestinal perforation, severe bleeding or fulminant disease. Their aim is for diagnosis and management to break the “vicious cycle” of damage to the gut wall from disease, infection, treatment, and more.
The authors also recommended a risk-stratified approach that matches patient characteristics with recommended empiric therapy is important in treating patients. Therapy, it is recommended, be tailored to the individual patient as what works for one patient may not work for another, they said.
PIDS members Joshua Wolf and Shane Cross, the authors, said about treatment, “Based on different risk criteria, we would expand the coverage of our antibiotics. Then…, as they improve, we take an approach where we try to step down with the antibiotic coverages as they get better to something that’s not quite as broad as other approaches…Close monitoring for improvement, deterioration, or development of intra-abdominal complications can guide subsequent management.”