Clinical practice patterns of managing low-risk adult febrile neutropenia during cancer chemotherapy in the USA

Abstract

US 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.

Expression of CD11b/CD18 adhesion molecules on circulating phagocytes—a novel aid to diagnose infection in patients with cancer

“…Physicochemical factors may also induce CD11b/CD18 up-regulation [5,9], which needs to be taken into account when processing the blood sample to avoid artifacts manifesting as false-positive high values [21,22]. The treatment of neutropenic infections is well-guided [2], and the studies of tailored instructions for patients of different risk-categories are currently ongoing [10]. Neutropenic infections were not our main interest, and in our randomly selected first series, only 12.3% of the patients had a white blood cell count of less than 1.5×10 9 /l.…”

Management of chemotherapy‐induced febrile neutropenia in pediatric oncology patients: A North American survey of pediatric hematology/oncology and pediatric infectious disease physicians

“…24 Outpatient management of patients with low-risk chemotherapyinduced FN has been successfully established in adults, with more than 80% of adult oncologists in the United States using this strategy. 26 The lower prevalence of outpatient management for FN in the pediatric population is likely related to the lack of widely validated guidelines for risk stratification and specific outpatient management practices. Several low-risk stratification schemas with similar efficacy and reliability have been reported.…”

Prevention of bacterial infection in pediatric oncology: What do we know, what can we learn?

“…Whereas quinolone prophylaxis has been widely adopted in adult oncology practice 60 its use is not routine in pediatric care, including care for those patients at highest risk. In a 2009 survey study only 13% of COG centers and 33% of BFM centers reported routinely prescribing prophylactic antibiotics to patients being treated for AML 49.…”