The Effect of a Neutropenic Diet on Infection and Mortality Rates in Cancer Patients: A Meta-Analysis
- 23 September 2015
- journal article
- research article
- Published by Informa UK Limited in Nutrition and Cancer
- Vol. 67 (8), 1232-1240
- https://doi.org/10.1080/01635581.2015.1082109
Abstract
Neutropenic diets (ND) are often prescribed to cancer patients aiming to reduce infection risk. The goal of this meta-analysis was to determine if ND indeed reduced the risk of infection and death in cancer patients compared to regular diets (RD). We identified studies in cancer patients that compared the effect of ND vs. RD on the risk of infections and mortality of any cause. The overall effect was calculated by use of a random effects model. Four studies were identified encompassing 918 patients. There was no difference in major infection or mortality rates between ND and RD groups. When analyzing for the overall composite outcome of any infection or fever, the hazard ratio was significantly higher in the ND arm (relative risk = 1.18, confidence interval: 1.05 to 1.34, P= 0.007). When the analysis was restricted to only the randomized trials, both groups had a comparable composite outcome. This meta-analysis shows no superiority with respect to mortality or infection of using a neutropenic diet in cancer patients. Larger studies are needed that study a broader range of nutritional issues, including the microbiome, in this patient population. Until then, it may be time to relax the restrictions of ND.Keywords
This publication has 25 references indexed in Scilit:
- Probiotics for the treatment ofClostridium difficileassociated diseaseWorld Journal of Gastrointestinal Pathophysiology, 2013
- The Cochrane Collaboration's tool for assessing risk of bias in randomised trialsBMJ, 2011
- Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious Diseases Society of AmericaClinical Infectious Diseases, 2011
- Examining low bacterial dietary practice: A survey on low bacterial foodEuropean Journal of Oncology Nursing, 2008
- Normal hospital and low-bacterial diet in patients with cytopenia after intensive chemotherapy for hematological malignancy: a study of safetyAnnals Of Oncology, 2007
- Random-effects model for meta-analysis of clinical trials: An updateContemporary Clinical Trials, 2007
- Saccharomyces boulardii produces a soluble anti-inflammatory factor that inhibits NF-κB-mediated IL-8 gene expressionBiochemical and Biophysical Research Communications, 2006
- Feasibility and Safety of a Pilot Randomized Trial of Infection Rate: Neutropenic Diet Versus Standard Food Safety GuidelinesJournal of Pediatric Hematology/Oncology, 2006
- Recognition of Commensal Microflora by Toll-Like Receptors Is Required for Intestinal HomeostasisCell, 2004
- Bacterial translocation: the influence of dietary variables.Gut, 1994