Resource implications of febrile neutropenia in cancer patients. An international collaborative study.
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.
Harbarth
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Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, Massachusetts, USA.
Beeler
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I
Viot
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M
Szucs
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TD
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