Ceftriaxone for the treatment of febrile episodes in nonneutropenic patients with hematooncological disease or HIV infection: comparison of outpatient and inpatient care.
BACKGROUND
Patients with hematooncological disease or HIV infection and febrile episodes are usually treated in hospital with broad-spectrum antibiotics. The aim of this observational study was to assess the feasibility of ambulatory parenteral antibiotic therapy in hematooncological or HIV-infected patients with confirmed or suspected infection.


METHODS
The results in an outpatient treatment group were compared with those obtained in a group initially treated in hospital. Data were gathered on 90 outpatients and 72 inpatients. The inclusion criteria were fever > or =37.5 degrees C with an identified focus of infection, fever > or =38.0 degrees C of suspected bacterial origin with no identified focus of infection, leukocytosis > or =9,000/microl or C-reactive protein elevation > or =10 mg/l.


RESULTS
Eighty outpatients and 69 inpatients were evaluable. Treatment in the outpatient group was begun with ceftriaxone. This led to defervescence in 87.5% of cases. The mean treatment duration was 7.1 days. Comparison of results in the outpatients with those initially hospitalized for treatment showed similar success rates. The mean hospital stay in the latter group was 12.9 days.


CONCLUSIONS
Ceftriaxone represents an effective treatment for outpatient management of febrile episodes in patients with hematooncological disease or HIV infection. Outpatient treatment is more cost-effective than inpatient care.
Egerer
G
G
Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany. gerline_egerer@med.uni-heidelberg.de
Goldschmidt
H
H
Müller
I
I
Karthaus
M
M
Günther
H
H
Ho
A D
AD
D000293:Adolescent; D000328:Adult; D000368:Aged; D002443:Ceftriaxone / Q000008:administration & dosage / Q000494:pharmacology*; D002511:Cephalosporins / Q000008:administration & dosage / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007223:Infant; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010045:Outpatients; D011446:Prospective Studies
D002511:Cephalosporins; D002443:Ceftriaxone