Advertisement
Am J Health-Syst Pharm
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


American Journal of Health-System Pharmacy, Vol. 64, Issue 7, 717-722
Copyright © 2007 by American Society of Health-System Pharmacists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Moores, K. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Moores, K. G.

Clinical Consultation

Safe and effective outpatient treatment of adults with chemotherapy-induced neutropenic fever

Kevin G. Moores

KEVIN G. MOORES, PHARM.D., is Associate Professor (Clinical) and Director, Division of Drug Information Service, College of Pharmacy, University of Iowa, 100 Oakdale Campus, N330OH, Iowa City, IA 52242-5000 (kevin-moores{at}uiowa.edu).


Purpose. The safe and effective outpatient treatment of adults with chemotherapy- induced neutropenic fever is reviewed.

Summary. Chemotherapy-induced neutropenic fever is a potentially life-threatening circumstance in high-risk patients. The standard of care for neutropenic fever is inpatient treatment with i.v. broad-spectrum antibiotics. Within the past 5–10 years, there has been growing interest in oral therapy and outpatient treatment for carefully selected low-risk patients. Outpatient treatment has the potential to avoid patient exposure to multidrug-resistant organisms found in the hospital, provide a more comfortable environment for the patient and his or her family, and achieve significant cost savings. Two risk-assessment tools have been developed to identify patients with a low risk of developing complications from neutropenic fever. A limited number of clinical trials have been conducted to evaluate outpatient treatment of low-risk patients. The evidence from well-designed randomized controlled trials comparing the safety and efficacy of outpatient therapy with standard therapy is not extensive. However, some centers have reported successful outpatient therapy in low-risk patients with febrile neutropenia. The greatest amount of evidence for outpatient treatment of neutropenic fever is available for the combination regimen of ciprofloxacin plus amoxicillin–clavulanate. Clinical practice guidelines are available to guide patient evaluation, antibiotic selection, monitoring, and follow-up.

Conclusion. The accepted standard for treatment of neutropenic fever remains inpatient therapy with i.v. broad-spectrum antibiotics. However, some centers have had success treating selected low-risk patients with neutropenic fever as outpatients.

Index terms: Amoxicillin; Antiinfective agents; Antineoplastic agents; Beta-lactamase inhibitors; Ciprofloxacin; Clavulanic acid; Combined therapy; Drug administration routes; Drugs; Economics; Methodology; Neutropenia; Patients; Penicillins; Protocols; Quinolones; Resistance; Toxicity

 



This article has been cited by other articles:


Home page
Mayo Clin Proc.Home page
M. A. Gertz, S. M. Ansell, D. Dingli, A. Dispenzieri, F. K. Buadi, M. A. Elliott, D. A. Gastineau, S. R. Hayman, W. J. Hogan, D. J. Inwards, et al.
Autologous Stem Cell Transplant in 716 Patients With Multiple Myeloma: Low Treatment-Related Mortality, Feasibility of Outpatient Transplant, and Effect of a Multidisciplinary Quality Initiative
Mayo Clin. Proc., October 1, 2008; 83(10): 1131 - 1135.
[Abstract] [Full Text] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American Society of Health-System Pharmacists.
Advertisement