ELSA-FN

authorAlannah Rudkin & Li-yin Goh
Key information

 

 

The ‘Early versus Late Stopping of Antibiotics in Children with Cancer and High-risk Febrile Neutropenia’ (ELSA-FN) is the first paediatric Electronic Medical Record (EMR) embedded randomised controlled trial in Australia and at The Royal Children’s Hospital (RCH). ELSA-FN is part of the continuing effort to improve care for children with cancer.

 

Study team

The ELSA-FN trial is a Centre for Health Analytics initiative in collaboration with the Melbourne Children’s Trials Centre, the Murdoch Children’s Research Institute Infection Flagship research program, and the Royal Children’s Hospital Children’s Cancer Centre.

Dr Gabrielle Haeusler – Principal Investigator

Dr Coen Butters – Co-investigator

Alannah Rudkin– Embedded trials project officer

Li-yin Goh– EMR analyst

Contact the study team at elsa.fn@mcri.edu.au

 

What we’re studying

After chemotherapy, children may have low neutrophils – a type of white blood cell that helps fight off infections. If they develop an infection and fever when they have low neutrophils (Febrile Neutropenia (FN)) it is a medical emergency and antibiotics have to be given quickly. Currently, there is no international consensus on how long to give a course of antibiotics in children with FN. US guidelines say to continue antibiotics until the child’s neutrophils increase but Euro guidelines say to stop antibiotics 48 hours after the fever has gone. This trial will compare both approaches.

While antibiotics are important for treatment of infection, unnecessary exposure has many adverse effects including:

  • Increased antimicrobial resistance
  • Risk of C. difficile and invasive fungal infection
  • Added cost
  • Disruption of the patient microbiome, with a range of secondary effects

Using the power of our data we can influence worldwide clinical best practice.

 

Who can get involved?

ELSA-FN is recruiting children with high-risk febrile neutropenia who are in the intensive phase of leukaemia/ lymphoma treatment, or within 100 days of stem cell transplant.

Children with cancer considered to have high-risk FN include those with acute leukaemia or lymphoma receiving high-intensity chemotherapy such as ‘induction chemotherapy’.