Survey on Dietary Restrictions for Neutropenic Patients

호중구감소환자의 식이제한 실태

  • Jeon, Ok-Kyung (Department of Nursing, Pusan National University Hospital) ;
  • Yim, Si-Eun (Department of Nursing, Pusan National University Hospital) ;
  • Jeong, Ihn-Sook (College of Nursing, Pusan National University) ;
  • Yun, Eun-Young (Department of Nursing, Silla University) ;
  • Kim, Mi-Hyun (Department of Nursing, Pusan National University Hospital) ;
  • Park, Yun-Sun (Department of Nursing, Pusan National University Hospital) ;
  • Lee, Su-Ran (Department of Nursing, Pusan National University Hospital)
  • 전옥경 (부산대학교병원 간호부) ;
  • 임시은 (부산대학교병원 간호부) ;
  • 정인숙 (부산대학교 간호대학) ;
  • 윤은영 (신라대학교 의생명과학대학 간호학과) ;
  • 김미현 (부산대학교병원 간호부) ;
  • 박윤선 (부산대학교병원 간호부) ;
  • 이수란 (부산대학교병원 간호부)
  • Received : 2010.06.22
  • Accepted : 2010.08.02
  • Published : 2010.08.31


Purpose: This survey was aimed to examine the current dietary restrictions practices for neutropenic patients among hospitals with 500 and more beds. Methods: Self-administered questionnaires were sent to 100 head or charge nurses of oncology or hemato-oncology wards by mail during October 2009, and 51 questionnaires were returned. The data were analyzed with descriptive statistics using SPSS (WIN version 12.0). Results: Of the hospitals surveyed, 47.1% (n=24) had guidelines on the dietary restrictions, and 80.4% (n=41) placed patients with neutropenia on restricted diets. The major decisional criteria of the dietary restriction was absolute neutrophil count (30.5%) and cooking status (29.2%). The most commonly restricted foods were raw fish or fresh meat (98.0%), uncooked intestine (98.0%), raw eggs (98.0%), draught beer (96.1%), and fresh fruits or vegetables (86.3%). Conclusion: The results showed variation in pattern of dietary restrictions and lower rate of guideline among hospitals, so that the need for the standard dietary restriction guideline is high. However, the role of diet in the development of infection in neutropenic patients is still unclear, which makes it difficult to establish dietary restriction guideline. Therefore, additional research are required to identify the relationship between dietary factors and infections.


  1. Kim NJ, Choe KW. Infections in neutropenic patients. J Infect Chemother 2000;18:369-77.
  2. Kim BJ, Kim YH, Jun MH, Choi JS, Gong SH, Seol ME, et al. Symptom management for cancer patients. Seoul : Hyunmoonsa. 2000.
  3. Barber FD. Management of fever in neutropenic patients with cancer. Nurs Clin North Am 2001;36:631-44.
  4. Moody K, Finlay J, Mancuso C, Charlson M. Feasibility and safety of a pilot randomized trial of infection rate: neutropenic diet versus standard food safety guidelines. J Pediatr Hematol Oncol 2006;28:126-33.
  5. Mank AP, Davies M, Research subgroup of the European Group for Blood and Marrow Transplantation Nurses Group (EBMTNG). Examining low bacterial dietary practice: a survey on low bacterial food. Eur J Oncol Nurs 2008;12:342-8.
  6. Loudon KW, Coke AP, Burnie JP, Shaw AJ, Oppenheim BA, Morris CQ. Kitchens as a source of Aspergillus niger infection. J Hosp Infect 1996;32:191-8.
  7. Wilson BJ. Dietary recommendations for neutropenic patients. Semin Oncol Nurs 2002;18:44-9.
  8. Moody K, Charlson M, Finlay J. The neutropenic diet: what's the evidence? J Pediatr Hematol Oncol 2002;24:717-21.
  9. van Tiel F, Harbers MM, Terporten PH, van Boxtel RT, Kessels AG, Voss GB, et al. Normal hospital and low-bacterial diet in patients with cytopenia after intensive chemotherapy for hematological malignancy: a study of safety. Ann Oncol 2007;18: 1080-4.
  10. Normen L, Bosaeus I, Ekman T. Nutritional therapy during bone marrow transplantation. An overview. Scand J Food Nutr 1996; 40(4):56-160.
  11. Centers for Disease Control and Prevention. Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. Morb Mortal Wkly Rep 2000;49(RR-10): 1-125.
  12. Gateway to government food safety information. Keep food safe. [cited 2010 March 14]. Available from: URL:
  13. Reheis CE. Symposium on infections in the compromised host. neutropenia. causes, complications, treatment, and resulting nursing care. Nurs Clin North Am 1985;20:219-25.
  14. Smith LH, Besser SG. Dietary restrictions for patients with neutropenia: a survey of institutional practices. Oncol Nurs Forum 2000;27:515-20.
  15. The Ohio State University Medical Center. Low bacterial diet. [cited 2010 March 14], Available from:URL:
  16. French MR, Levy-Milane R, Zibrik D. A survey of the use of low microbial diets in pediatric bone marrow transplant programs. J Am Diet Assoc 2001;101:1194-8.
  17. Moe GL. Low microbial diets for patients with granulocytopenia. In A. S. Bloch (Ed). Nutrition management of the cancer patient . Rockville, MD: Aspen Publication 1990;125-33.
  18. Carter LW. Influences of nutrition and stress on people at risk for neutropenia : nursing implications. Oncol Nurs Forum 1993; 20:1241-50.
  19. Hwang EM. Analysis and evaluation of Vancomycin use [dissertation]. Seoul:Ewha Womans Univ.; 2008.