title: Resource implications of febrile neutropenia in cancer patients. An international collaborative study.
abstract: No previous study has compared countries with respect to differences in clinical practice and resource use of cancer patients with febrile neutropenic episodes (FNE). The purpose of this international, cross-sectional pilot study conducted in tertiary care centers across Europe, Brazil and Australia was to evaluate the resource use attributable to febrile neutropenia in different countries. A total of 17 centers from eight countries provided 128 patients. The leading malignant disorders were hematological malignancies (n = 47), lymphomas (n = 27), and breast cancer (n = 26). The median length of duration of FNE was 4 days (interquartile range, 3-8). The incidence density of antimicrobial exposure was 4.691 days of antimicrobial therapy per 1,000 days of FNE. There were 23 patients who received a total of 280 days of G-CSF therapy. On average, 5 (+/-5.4) blood samples per patient were drawn and cultured. The most common diagnostic radiographic test was the chest X-ray, with a total of 224 such examinations performed in 82 patients. We conducted an international cross-sectional study on resource implications of febrile neutropenia in cancer patients. The records of the febrile neutropenic patients included in this study reflect clinical practice in a heterogeneous, international patient population, treated with modern supportive care and early empiric antibiotics by clinicians at different levels of expertise.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, Massachusetts, USA.
authors.forename: S
authors.initials: S
authors.lastname: Harbarth
authors.forename: I
authors.initials: I
authors.lastname: Beeler
authors.forename: M
authors.initials: M
authors.lastname: Viot
authors.forename: T D
authors.initials: TD
authors.lastname: Szucs
mesh_terms: D000328:Adult; D001315:Australia; D001938:Brazil; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D005335:Fever of Unknown Origin / Q000628:therapy*; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D009503:Neutropenia / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies