SELF-ADMINISTERED ANTIBIOTIC-THERAPY FOR CHEMOTHERAPY-INDUCED, LOW-RISK FEBRILE NEUTROPENIA IN PATIENTS WITH NONHEMATOLOGIC NEOPLASMS

A multicenter prospective nonrandomized trial was conducted to evaluat e the efficacy of self-administered oral ofloxacin in the treatment of cancer patients with fever and neutropenia. Patients receiving chemot herapy who either resided far away and H ere unable to reach the oncol ogy ward within 12 hours of the onset of fever or were unable to affor d the expensive inpatient care were eligible for inclusion in the stud y. Requirements for enrollment included an absolute neutrophil count o f less than or equal to 0.5 x 10(9)/L, a temperature of >38 degrees C, and the ability to take oral medications. The patients were instructe d to immediately self-administer oral ofloxacin on recognition of feve r and to maintain daily telephonic contact with the oncology staff. On e-hundred eleven such episodes were evaluable. Neutropenia was mostly of short duration (87% of episodes, less than or equal to 1 week); 92 (83%) of the febrile episodes responded to ofloxacin with resolution o f fever and neutropenia (hospitalization was not required). Two episod es resulted in death before the patients could be brought to the hospi tal; 17 (15%) did not respond to ofloxacin, and the patients required hospitalization. The conditions of all except one improved with parent eral combination antibiotic therapy. No toxicity was observed, and the cost of therapy was negligible. Treatment with oral ofloxacin may pos sibly serve as an alternative to hospitalization for those who are oth erwise at low risk of morbidity and death.