Outpatient treatment of low-risk neutropenic fever in cancer patients using oral moxifloxacin.
BACKGROUND
Oral-based antibiotic therapy is the standard of care in the management of cancer patients with low-risk neutropenic fever. Nevertheless, to the authors' knowledge, the best antibiotic regimen and the feasibility of ambulatory treatment have not been clearly defined.


METHODS
The authors evaluated the efficacy and safety of moxifloxacin as outpatient treatment in cancer patients with febrile neutropenia who were selected according to the recently proposed Multinational Association for Supportive Care in Cancer (MASCC) risk assessment model. Moxifloxacin was given at a dose of 400 mg orally once daily.


RESULTS
Fifty-four patients with solid and hematologic malignancies, the majority of whom (84%) had advanced disease, were included in the current study. The median neutrophil count at the time of study entry was 340/mm3 (range, 20-950/mm3) and the median duration of neutropenia was 4 days (range, 3-14 days). Of 55 neutropenic episodes, 50 (91%) had a successful outcome with a median time to defervescence of 2 days (range, 1-5 days). A multivariate analysis indicated that severe neutropenia (an absolute neutrophil count of < 100 mm3) was the only independent factor associated with treatment failure (P < 0.04). Moxifloxacin was found to be well tolerated and there were no infectious deaths reported.


CONCLUSIONS
The results of the current study demonstrated that moxifloxacin was a highly effective and safe regimen in the outpatient treatment of cancer patients with febrile neutropenia.
Chamilos
Georgios
G
Department of Clinical Therapeutics, University of Athens Medical School, Athens, Greece. Gchamilo@mdanderson.org
Bamias
Aristotle
A
Efstathiou
Eleni
E
Zorzou
Pagona M
PM
Kastritis
Efstathios
E
Kostis
Evagelos
E
Papadimitriou
Christos
C
Dimopoulos
Meletios A
MA
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001372:Aza Compounds / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000188:drug therapy*; D024841:Fluoroquinolones; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy*; D011804:Quinolines / Q000627:therapeutic use*; D018570:Risk Assessment; D012449:Safety; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin