Oral Antibiotics vs. Intravenous Antibiotics for Low-Risk Febrile Neutropenia in Cancer Patients
Author Information
Author(s): Innes H E, Smith D B, O'Reilly S M, Clark P I, Kelly V, Marshall E
Primary Institution: Clatterbridge Centre for Oncology
Hypothesis
Can oral antibiotics with early hospital discharge be as effective as in-patient intravenous antibiotics for low-risk febrile neutropenia in cancer patients?
Conclusion
Oral antibiotics combined with early hospital discharge are a feasible and cost-effective alternative to conventional in-patient management for low-risk febrile neutropenia.
Supporting Evidence
- 90% success rate in the intravenous arm and 84.8% in the oral arm.
- Median hospital stay was 4 days for intravenous and 2 days for oral treatment.
- Total costs were significantly lower in the oral arm, saving over £19,000.
Takeaway
This study shows that patients with low-risk febrile neutropenia can safely take oral antibiotics and go home sooner instead of staying in the hospital.
Methodology
A single-centre randomised trial comparing oral antibiotics with early discharge to standard intravenous antibiotics in low-risk neutropenic patients.
Potential Biases
Potential bias due to the non-blinded nature of the study and strict eligibility criteria.
Limitations
The study was conducted at a single specialist centre, which may limit the generalizability of the findings.
Participant Demographics
Patients were primarily adults undergoing conventional dose cytotoxic chemotherapy, with a median age of 50-53 years and a majority being female.
Statistical Information
P-Value
0.55
Confidence Interval
95% CI for success rate difference: -7 to 17.3%
Statistical Significance
p=0.55
Digital Object Identifier (DOI)
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