OUTPATIENT MANAGEMENT OF FEBRILE EPISODES IN NEUTROPENIC CANCER-PATIENTS

Febrile neutropenic patients have traditionally received hospital-base d parenteral antibiotic therapy because of the risk of serious complic ations and associated mortality. Recently a low-risk subset among febr ile neutropenic patients has been identified. Several alternatives to hospital-based therapy have been evaluated in such patients. These inc lude early discharge to home antibiotic therapy after initial stabiliz ation in the hospital, or treatment of the entire febrile episode with intravenous and/or oral antibiotics in an ambulatory setting. A multi disciplinary approach involving the physician and other health-care pr oviders, the patients, and their families, ensures the success of this therapeutic modality. Careful patient selection, daily follow-up, clo se monitoring for the development of complications and/or adverse reac tions, and informed consent along with detailed instructions to patien ts, minimize the risk of the development of serious complications. Out patient antibiotic therapy for febrile episodes in low-risk neutropeni c patients should now be considered an acceptable alternative to hospi tal-based therapy.