Tratamiento de la neutropenia febril secundaria a quimioterapia, con antibióticos orales de modo ambulatorio

Abstract

Purpose: To analyze whether oral antibiotic therapy is effective for patients under outpatient regime having a low risk febrile neutropenta. Material and methods: An observational, prospective study of 10 patient's meeting the criteria of low risk neutropenia is made. Quinolones were administered, emplpying ciprofloxacin in 8 cases and levofloxacin in the other 2 during 10-14 days. The first three cases seen received also filgastrim. The patients were followed-up after 24 hours, and then every 48-72 hours until the febrile neutropenia resolved. Results: Fever disappeared within 48 hours in 5 cases and within 72 hours in 3 patients. A low grade fever remained in 2 cases, that according to the authors was cancer-related and not caused by neutropenia. The hematological control showed a neutrophil count over 500 per mm3 after 48 hours in 3 cases, and 4 days after the beginning of the episode a count over 500 was found in five out of the six remaining patients. No patient required hospitalizarion. As an additional preventive measure, the next chemotherapy course was delayed one week and the dose reduced to 25% of the total dose. Conclusions: Oral antibiotic therapy under outpatient regime is effective for patients with low-risk febrile neutropenia, thus avoiding unnecessary hospital admissions and complications.