BACKGROUND AND OBJECTIVE: Febrile neutropenia (FN) frequently develops among cancer patients receiving chemotherapy and is associated with significant morbidity and mortality. Although the use of empiric antibiotics has been a standard of care for FN according to the last 2010 Infectious Disease Society of America (IDSA) guidelines, the role of prophylactic antibiotics in patients with high risk features in preventing febrile neutropenia remains to be elucidated. This study aims to investigate the role of antibiotic prophylaxis in preventing post-chemotherapy FN among patients with hematologic and solid organ malignancies.

METHODS: A literature search of published English language clinical trials was performed using PubMed, MEDLINE, and the Cochrane Collaboration from January 1980 - October 2015. Four hundred thirty two articles were extracted from our literature search and narrowed down through specified inclusion and exclusion criteria. Results were analyzed based on 1) incidence of FN in post chemotherapy cancer patients, 2) mortality rate, and 3) incidence of FN with different antibiotics. Assessment of methodological quality of each study was done using the Jadad scale. Odds ratios and Forest plots were computed and generated respectively using RevMan 5.2 (© 2013 the Cochrane Collaboration).

RESULTS: Antibiotic prophylaxis reduced the incidence of FN (OR 0.59[0.37, 0.91]). Overall effect was significant; Z= 2.35 (p= 0.02). Febrile episodes occurred less frequently in those patients who received prophylactic antibiotic treatment (OR 0.43 [0.34, 0.53]) Z = 7.59 (p< 0.00001). The combined results in this sub-analysis on different antibiotic regimens used demonstrated that prophylaxis in general prevented FN by up to 3.51-fold among cancer patients who received chemotherapy, OR 3.51[3.10, 3.98]. Results were statistically significant at Z = 19.68, p < 0.00001.

CONCLUSION: Antibiotic prophylaxis reduces the incidence of FN among cancer patients treated with cytotoxic chemotherapy, decreases febrile episodes in neutropenic patients, and overall, prevented FN by up to 3.51-fold.

Human ; Male ; Female ; Middle Aged ; Antibiotic Prophylaxis ; Anti-bacterial Agents ; Medline ; Fever ; Pubmed ; Morbidity ; Neoplasms ; Febrile Neutropenia ; Forests

The Philippines, with a maximum personal income tax rate at 32%1 and a corporate income tax of 35%,1 has one of the highest income tax rates among the Association of South East Asian(ASEAN) member states.2 The new administration is now campaigning to lower the ceilings on capital and personal income tax, through a proposal originally passed in September 2016, and amended in January 2017, following public and private sector opposition for its immediate imposition.3 In its Explanatory Note, House Bill No. 292, "An Act Imposing Excise Tax on Sugar-Sweetened Beverages by Inserting a New Section 150-A in the National Internal Revenue Code of 1997, as Amended," cites this as the reason for imposing an, "excise tax of ten pesos (Php 10.00) on sugar-sweetened beverages, the rate of which shall be increased by four percent (4%) every year thereafter effective on January 1, 2017."4 According to the proposed bill, "this measure is proposed to provide additional revenue collections for our country," further claiming that, "this house bill is timely in its submission as one of the new administration's policies to pursue reforms in income tax rates.

Achievement of Universal Health Care (UHC) in the Philippines requires capable health workers who can navigate changes and lead in the local implementation of health system reforms. Public health nurses are in a strategic position to lead in UHC implementation as they constitute the largest cadre of health workers in the public health setting, and core concepts of UHC intersect with principles of public health nursing practice. This paper aims to describe the development and implementation of a leadership training program for public health nurses in the Philippines, in response to UHC. Document reviews of training reports and evaluations, including course site data analytics, and evaluation of the training program were done for the four cohorts of the course. The University of the Philippines Manila College of Nursing, with support from the Department of Health, responded to the increased demand of the Philippine health system for public health nurses with strong foundations and advanced skills by designing and offering a leadership development course specific to PHNs. From November 2019 to March 2022, a total of 183 participants from 17 regions completed the training. With the COVID-19 pandemic and dynamic changes in governance, the experiences of the project highlighted the need for flexibility in delivering the training program, updating module contents according to the latest developments, and improving course duration and evaluation. Barriers to course engagement and completion must be addressed for PHNs, their workplaces, clients, and the health system to benefit the most from the training.
Nurses, Public Health ; Universal Health Care ; Nursing

INTRODUCTION: Under COVID-19 guidelines, families are spending extended hours together within limited physical space, giving rise to a living situation that can bring families closer together and/or lead to conflicts. This study aimed to determine the current state of household cohesion and conflict among families with confirmed COVID-19 cases in the Philippines. METHODS: This was a cross-sectional study using the COVID-19 Household Environment Scale (CHES) as a self-administered questionnaire among adult persons who belonged to households with at least one family member previously diagnosed or currently with COVID-19 in August and September 2021. Participants were recruited online using convenience and snowball sampling. The CHES is a 30-item tool which measures conflict and cohesion through the Conflict and Togetherness Subscales, respectively. RESULTS: The composite median values of 386 participants surveyed reveal scores that were clustered to the left for the Conflict Subscale and neutrality for the Togetherness Subscale. CONCLUSION There is a general increase in household conflict and a non-significant change in togetherness among the surveyed families. The composite median values, if taken compoundly, imply the existence of more conflict and less togetherness.