Outpatient antibiotic treatment in low-risk febrile neutropenic cancer patients.
Traditionally febrile neutropenic patients have been treated with parenteral antibiotics in an inpatient setting; however, recent work by several investigators has demonstrated successful treatment with both parenteral and oral antibiotics in an ambulatory environment. This has been accomplished by identification of low-risk neutropenic patients, advances in broad-spectrum antibiotics with long half-lives and stabilities, the introduction of the oral quinolones, home health-care initiatives, improvements in vascular access devices, and development of technically enhanced antibiotic delivery systems. Outpatient antibiotic therapy for febrile episodes in low-risk neutropenic patients should now be considered an acceptable alternative to hospital-based treatment. This review focuses on the development and rationale of risk stratification and examines the results of various outpatient antibiotic trials recently completed.
Escalante
C P
CP
Department of Medical Specialties, University of Texas, M.D. Anderson Cancer Center, Houston 77030-4095, USA.
Rubenstein
E B
EB
Rolston
K V
KV
D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005334:Fever / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D010045:Outpatients; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents