A Melbourne-developed treatment decision model - which allows young cancer patients to avoid a hospital stay and instead recover from mild infections at home - is now being adopted by UK hospitals.

Developed by Prof Karin Thursky and Prof Monica Slavin from Peter Mac, and Dr Gabrielle Haeusler from Peter Mac and Murdoch Children’s Research Institute, the “AUS-rule” tool has been successfully introduced by several Australian hospitals to reduce paediatric hospital stays.

Adoption is now being fast-tracked in the UK where benefits also include freeing-up hospital resources for COVID-19.

AUS-rule helps doctors decide which children with febrile neutropenia (FN) – which is fever with a low white blood cell count - are suitable for home management using antibiotics and temperature monitoring.

This is a common complication of childhood cancer care, and a major cause of hospital admission.

"Over half of these patients do not have a severe infection and can be treated at home with antibiotics and the appropriate supports,” Dr Haeusler says.

“This reduces their time spent in hospital by 3-4 days and allows kids to recover in the comfort of their own home.

“We are currently in the process of scaling up the program across Australia so more children with cancer can benefit from this research.”

To develop AUS-rule, Dr Haeusler and Prof Thursky recalibrated a FN decision rile with input from UK and Swiss researchers. The AUS-rule (Australia-UK-Switzerland) name reflects this international collaboration.

Dr Bob Phillips, who is leading the UK roll-out, says it early days but it was proving popular with families who had trialed it in Leeds, London, and Liverpool. 

Of the 32 children who have presented with FN at Leeds Teaching Hospital since April this year, nine have gone home with support and an antibiotic treatment plan within a day, compared to a usual minimum hospital stay of three days.

“It means that we don’t do unnecessary tests on kids and just annoy them, and they actually do better at home,” Dr Phillips said.

“It’s been wonderful to have the direct support of Dr Haeusler and the Australian teams in implementing this program in the UK.”

Dr Phillips said the more AUS-rule was shown to work “across different hospitals in different countries, the more robust it is because it’s experiencing variation and being effective”.

A paper “Re-evaluating and recalibrating predictors of bacterial infection in children with cancer and febrile neutropenia”, authored by Dr Haeusler and colleagues, was published this month in the journal E Clinical Medicine.

Find the paper here or you can also access the AUS-rule guidelines here.