EARLY HOSPITAL DISCHARGE OF CHILDREN WITH FEVER AND NEUTROPENIA - A PROSPECTIVE-STUDY

Purpose: We report a prospective study on brief IV antibiotic therapy in selected children with cancer experiencing fever and neutropenia (F N) after chemotherapy. Patients and methods: All children with FN (T d egrees greater than or equal to 38 degrees C; ANC<0.5x10(9)/L) were ho spitalized for treatment with broad spectrum IV antibiotics. They were divided into three groups: group A (no infection), group B (clinicall y documented infection). and group C (bacteremia), Children in group A (and some children in group B) were discharged before recovery of neu tropenia, if afebrile and in good condition. Results: Eighty-eight con secutive episodes of FN occurred in 30 children. Children in group A ( 44 episodes; 50%) received IV antibiotics for a median of 3 days; on 2 5 occasions (57%), IV antibiotics were stopped before recovery of neut ropenia. In children in group B (30 episodes; 34%), early discharge wa s allowed in eight cases of minor infections (27%); sire received oral antibiotics. Two children (group A) were rehospitalized for recurrent FN but recovered without complications. Conclusion: In chemotherapy-i nduced neutropenia, children hospitalized for fever but without docume nted infections and some children with minor infections can cautiously be discharged before evidence of bone marrow recovery if afebrile and in good general condition.