Abstract
BackgroundFebrile neutropenia is an oncologic emergency. The timing of antibiotics administration in patients with febrile neutropenia may result in adverse outcomes. Our study aims to determine time-to- antibiotic administration in patients with febrile neutropenia, and its relationship with length of hospital stay, intensive care unit monitoring, and hospital mortality.MethodsThe study population was comprised of adult cancer patients with febrile neutropenia who were hospitalized, at a tertiary care hospital, between January 2010 and December 2011. Using Multination Association of Supportive Care in Cancer (MASCC) risk score, the study cohort was divided into high and low risk groups. A multivariate regression analysis was performed to assess relationship between time-to- antibiotic administration and various outcome variables.ResultsOne hundred and five eligible patients with median age of 60 years (range: 18–89) and M:F of 43:62 were identified. Thirty-seven (35%) patients were in MASCC high risk group. Median time-to- antibiotic administration was 2.5 hrs (range: 0.03-50) and median length of hospital stay was 6 days (range: 1–57). In the multivariate analysis time-to- antibiotic administration (regression coefficient [RC]: 0.31 days [95% CI: 0.13-0.48]), known source of fever (RC: 4.1 days [95% CI: 0.76-7.5]), and MASCC high risk group (RC: 4 days [95% CI: 1.1-7.0]) were significantly correlated with longer hospital stay. Of 105 patients, 5 (4.7%) died & or required ICU monitoring. In multivariate analysis no variables significantly correlated with mortality or ICU monitoring.ConclusionsOur study revealed that delay in antibiotics administration has been associated with a longer hospital stay.
Highlights
IntroductionOur study aims to determine time-to- antibiotic administration in patients with febrile neutropenia, and its relationship with length of hospital stay, intensive care unit monitoring, and hospital mortality
The current study aims to determine time-to- antibiotic administration in adult cancer patients with febrile neutropenia, a quality measure in cancer care; and to assess the relationship between time-to- antibiotic administration and length of hospital stay, intensive care unit (ICU) monitoring, and hospital mortality
To determine relationship between time-to- antibiotic administration and ICU monitoring or hospital mortality in adult cancer patients with febrile neutropenia treated with chemotherapy
Summary
Our study aims to determine time-to- antibiotic administration in patients with febrile neutropenia, and its relationship with length of hospital stay, intensive care unit monitoring, and hospital mortality. An infectious source is identified in approximately 20 to 30% of episodes of neutropenia and fever [3], empiric broad spectrum antibiotics are the universal therapy for patients with febrile neutropenia. It involves the initiation of antimicrobial therapy in patients with neutropenia, at the time of the onset of fever, without establishing a. Several studies assessed time-to- antibiotic administration in cancer patients presenting to emergency department (ED) with febrile neutropenia [6,7,8,9]. Delayed antibiotic administration was not associated with increased risk of death or increased length of hospital stay [9]
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