Major infection in leukaemia patients consuming a regular versus neutropenic diet

Abstract

Overview and Research Question: The neutropenic diet (ND) is a low bacterial diet that is recommended to patients who are immunosuppressed, such as patients with leukaemia, in order to reduce their chances of acquiring infections. Because of the uncertainty of its’ efficacy in doing so, the research question, ‘Does a neutropenic versus regular diet impact infection rates in leukaemia patients?’, was investigated to guide evidence-based practice. Its’ respective PICO elements are as follows; P- Leukaemia patients I- Neutropenic diet C-Regular diet. O- Rates of infection Study Selection and Criteria: Studies in English that were peer-reviewed, and either systematic reviews, meta-analyses and/or RCTs, published in the last 15 years were chosen. Population included patients with leukaemia of all ages. The intervention was the neutropenic diet (ND) or any diet that aimed to reduce infection rates and restricted the consumption of raw fruit and vegetables. The comparison was regular diet (RD) or any diet that abided by the food safety guidelines. Lastly, it was imperative that rate of infection was the primary outcome. The expected outcome was no difference between the efficacy of the neutropenic diet and that of the regular diet in reducing infection rates in leukaemia patients. Methods: Search terms, limiters and keywords were identified focusing on the PICO question. Four database platforms and Google Scholar were used to identify relevant articles. A PRISMA framework was designed and the CASP tool was used to facilitate the appraisal process. Results: The 3 meta-analyses and single RCT used indicated that the neutropenic diet was not superior in reducing infection rates in patients with leukaemia over the regular diet. Further research of higher quality and less bias is recommended. Recommendations and Future Implementation: More robust research is needed to conclusively determine whether the neutropenic diet can be eliminated from being an infection prevention option for leukaemia patients. The research will require more linearity, larger sample sizes and higher quality studies to be used. For future advancements, more education, awareness and financial backing is required.