ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2008
Clinical practice patterns of managing low-risk adult febrile neutropenia during cancer chemotherapy in the USA.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Oral versus intravenous antibiotic treatment for febrile neutropenia in cancer patients.The Cochrane database of systematic reviews · 2013Pooled it
- Safety of early discharge for low-risk patients with febrile neutropenia: a multicenter randomized controlled trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2011Trial
- Efficacy of oral levofloxacin monotherapy against low-risk FN in patients with malignant lymphoma who received chemotherapy using the CHOP regimen.Journal of clinical and experimental hematopathology : JCEH · 2020Article
- Challenges in rehabilitation of patients with nontraumatic spinal cord dysfunction due to tumors : A narrative review.Wiener klinische Wochenschrift · 2019Review
- Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2019Article
- The MASCC Neutropenia, Infection and Myelosuppression Study Group evaluates recent new concepts for the use of granulocyte colony-stimulating factors for the prevention of febrile neutropenia.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2013Article
- The Multinational Association for Supportive Care in Cancer (MASCC) risk index score: 10 years of use for identifying low-risk febrile neutropenic cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2013Review
- Deviations from guideline-based therapy for febrile neutropenia in cancer patients and their effect on outcomes.JAMA internal medicine · 2013Article
- Health-related quality of life anticipated with different management strategies for febrile neutropenia in adult cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2012Article
- Prevention of bacterial infection in pediatric oncology: what do we know, what can we learn?Pediatric blood & cancer · 2012Article
- Advances in the treatment of neutropenia.Current opinion in supportive and palliative care · 2009Review
- Expression of CD11b/CD18 adhesion molecules on circulating phagocytes-a novel aid to diagnose infection in patients with cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2008Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of the study was to determine oncologists' current practice patterns for antibiotic management of low-risk fever and neutropenia (FN) after chemotherapy. MATERIALS AND
methodsA self-administered survey was developed to query management practices for low-risk FN patients and sent to 3,600 randomly selected American Society of Clinical Oncology physician members; hypothetical case scenarios were included to assess factors influencing decisions about outpatient treatment.
resultsOf 3,560 actively practicing oncologists, 1,207 replied (34%). Outpatient antibiotics are used by 82% for selected low-risk FN patients (27% used in them >65% of their patients). Oral levofloxacin (50%), ciprofloxacin (36%), and ciprofloxacin plus amoxicillin/clavulanate (35%) are common outpatient regimens. Fluoroquinolone prophylaxis is used by 45% of oncologists, in a subset of afebrile patients at low risk for FN; growth factors are used adjunctively by 48% for treating low-risk FN. Factors associated with choosing outpatient treatment were: frequency of use in oncologists' own practices, absence of hematologic malignancy, lower patient age, no infiltrate on X-ray, no prior serious infection, shorter expected FN duration, lower creatinine levels, and shorter distance of patient's residence from the hospital.
conclusionsUS oncologists, who responded are willing to prescribe outpatient oral antibiotic treatment for low-risk FN, although practices vary considerably and are based on favorable clinical factors. However, practices are often employed that are not recommended for low-risk patients by current guidelines, including fluoroquinolone prophylaxis, adjunctive and/or prophylactic growth factors, and use of levofloxacin for empiric therapy. Educational efforts are needed to better guide cost-effective and supportive care.
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