caa a22 4500 463256298 CHVBK 20180405153356.0 cr unu---uuuuu 170326e20070401xx s 000 0 eng 10.1007/s00277-006-0248-4 doi (NATIONALLICENCE)springer-10.1007/s00277-006-0248-4 Early hospital discharge with oral antimicrobial therapy in patients with hematologic malignancies and low-risk febrile neutropenia [Elektronische Daten] [Corrado Girmenia, Eleonora Russo, Ida Carmosino, Massimo Breccia, Francesco Dragoni, Roberto Latagliata, Sergio Mecarocci, Salvatore Morano, Caterina Stefanizzi, Giuliana Alimena] Although consensus exists relating criteria for the identification of low-risk patients with febrile neutropenia, no clear indication on how to manage these patients has been so far provided particularly in outpatients affected by hematologic malignancies. The feasibility and safety of early discharge was prospectively evaluated in 100 outpatients with hematologic malignancies and febrile neutropenia. A strategy considering the risk-index of the Multinational Association of Supportive Care in Cancer (MASCC) was applied. High-risk patients were entirely managed at hospital. Low-risk patients were early discharged if they were afebrile since 48h and not on supportive therapy requiring hospitalization. Out of 90 low-risk episodes, in 69 instances (76.7%), patients were discharged after a median of 4days and continued home therapy with oral cefixime (78%) or other antibiotics. Only five outpatients (7.2%) had fever recurrence. Twenty-one low-risk patients were not early discharged due to worsening conditions (three deaths), need of multiple daily dose therapy, or discharge refuse. No clinical characteristic was able to predict the eligibility for early discharge. The MASCC risk-index is a useful aid in the identification of high-risk febrile neutropenia needing whole in-hospital treatment. As for low-risk patients, hospitalization at least in the first days of fever is required. Cefixime could be included among the oral antibacterial drugs to be used in the outpatient treatment of adult patients with febrile neutropenia. Springer-Verlag, 2007 Febrile neutropenia nationallicence Hematologic malignancies nationallicence Outpatient nationallicence Early discharge nationallicence Cefixime nationallicence Girmenia Corrado Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut Russo Eleonora Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut Carmosino Ida Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut Breccia Massimo Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut Dragoni Francesco Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut Latagliata Roberto Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut Mecarocci Sergio Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut Morano Salvatore Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut Stefanizzi Caterina Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut Alimena Giuliana Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut Annals of Hematology Springer-Verlag 86/4(2007-04-01), 263-270 0939-5555 86:4<263 2007 86 277 https://doi.org/10.1007/s00277-006-0248-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00277-006-0248-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Girmenia Corrado Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut NATIONALLICENCE 700 1- Russo Eleonora Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut NATIONALLICENCE 700 1- Carmosino Ida Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut NATIONALLICENCE 700 1- Breccia Massimo Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut NATIONALLICENCE 700 1- Dragoni Francesco Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut NATIONALLICENCE 700 1- Latagliata Roberto Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut NATIONALLICENCE 700 1- Mecarocci Sergio Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut NATIONALLICENCE 700 1- Morano Salvatore Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut NATIONALLICENCE 700 1- Stefanizzi Caterina Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut NATIONALLICENCE 700 1- Alimena Giuliana Dipartimento di Biotecnologie Cellulari ed Ematologia, Università "La Sapienza”, Via Benevento 6, 00161, Rome, Italy aut NATIONALLICENCE 773 0- Annals of Hematology Springer-Verlag 86/4(2007-04-01), 263-270 0939-5555 86:4<263 2007 86 277 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer