SUPPORTIVE CARE OF CHILDREN WITH CANCER: PROPHYLAXIS AGAINST INFECTIOUS COMPLICATIONS IN PATIENTS WITH CENTRAL CATHETERS

A.     Background

In-dwelling central catheters are common in children receiving chemotherapy. These children frequently require operations or other invasive procedures and, much as patients with congenital heart disease, are at risk for colonization of the catheter during episodes of transient bacteremia.

B.     Recommendations

All patients with indwelling central catheters (of either the external catheter type or the subcutaneous reservoir type) should receive standard prophylaxis against subacute bacterial endocarditis, as recommended by the American Heart Association, during invasive procedures, including operations on the gastrointestinal or genitourinary tract, endotracheal intubation, and dental manipulation.

1.     Standard regimen

Amoxicillin 50 mg/kg (maximum 2 g) PO 1 hour before the procedure.

2.     Regimen for patients allergic to penicillin

Clindamycin 20 mg/kg (maximum 600 mg) PO 1 hour before the procedure or 20 mg/kg (maximum 600 mg) IV within 30 minutes before the procedure.

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Cancer