title: Use of risk stratification to guide ambulatory management of neutropenic fever. Australian Consensus Guidelines 2011 Steering Committee.
abstract: Utilization of risk-stratification tools in the setting of neutropenic fever is currently limited by inadequate knowledge and lack of awareness. Within this context, the approach to management of low-risk patients with neutropenic fever is inconsistent with the available evidence across many Australian treating centres. These clinical guidelines define and clarify an accepted standard of care for this patient group given the current evidence base. The Multinational Association for Supportive Care in Cancer risk index is presented as the preferred risk assessment tool for determining patient risk. Suitability of ambulatory care within specific patient populations is discussed, with defined eligibility criteria provided to guide clinical decision-making. Detailed recommendations for implementing appropriate ambulatory strategies, such as early discharge and outpatient antibiotic therapy, are also provided. Due consideration is given to infrastructural requirements and other supportive measures at a resourcing and operational level. An analysis of the relevant health economics is also presented.
authors.affiliation: Department of Infectious Diseases, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia. Leon.Worth@petermac.org
authors.forename: L J
authors.initials: LJ
authors.lastname: Worth
authors.forename: S
authors.initials: S
authors.lastname: Lingaratnam
authors.forename: A
authors.initials: A
authors.lastname: Taylor
authors.forename: A M
authors.initials: AM
authors.lastname: Hayward
authors.forename: S
authors.initials: S
authors.lastname: Morrissey
authors.forename: J
authors.initials: J
authors.lastname: Cooney
authors.forename: P A
authors.initials: PA
authors.lastname: Bastick
authors.forename: R W
authors.initials: RW
authors.lastname: Eek
authors.forename: A
authors.initials: A
authors.lastname: Wei
authors.forename: K A
authors.initials: KA
authors.lastname: Thursky
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods* / Q000458:organization & administration; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001315:Australia; D002173:Cancer Care Facilities / Q000458:organization & administration / Q000592:standards; D019468:Disease Management; D024901:Drug Resistance, Multiple, Bacterial; D019317:Evidence-Based Medicine; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000150:complications*; D010348:Patient Care Team; D010351:Patient Discharge; D010818:Practice Patterns, Physicians'; D012008:Recurrence; D012306:Risk; D012308:Risk Management; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents