Outpatient therapy in patients with febrile neutropenia

Abstract

Treatment of patients with neoplasia and febrile neutropenia, as a consequence of chemotherapy, poses many doubts, among them the need for hospitalization, since this implies exposure to potentially resistant nosocomial microorganisms. Even under the best isolation techniques, there may be risks for individuals whose immune system may not be in optimal conditions. Multiple studies have tried to validate methods for classifying patients with febrile neutropenia according to their risk of complications. Such classification systems could be the base for implementing selective treatment strategies, one of which would be the oral ambulatory administration of wide-spectrum antibiotics. Neutropenia is one of the serious consequences of cancer chemotherapy, and it has been demonstrated that intravenous antibiotic treatment reduces mortality. Therefore, oral therapy could constitute an acceptable alternative for well-selected patients but the need for applying good clinical judgement, properly following up patients, and the availability of immediate access to medical attention should be emphasized. The following are among the potential benefits of oral treatment: better quality of life for patients and their families, avoidance of the complications associated with intravenous therapy, and diminished costs of health care.