A comparison of ED and direct admission care of cancer patients with febrile neutropenia

Owolabi, Diwura; Rowland, Richard H.; King, Lauren M.; Miller, Rick; Hegde, Gajanan G.; Shang, Jennifer; Lister, John; Venkat, Arvind

doi:10.1016/j.ajem.2015.04.028

Cited by 8 publications

(3 citation statements)

References 10 publications

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“…Additionally, patients with febrile neutropenia presenting to the ED were also found to receive comparable treatment times as those who were directly admitted from the outpatient setting. 10 There is a dearth of literature about an effective process of administering TTA # 60 minutes to patients with BMT in the ED setting. Since there are no guidelines for patients with febrile non-neutropenic BMT regarding antibiotic administration, a self-monitoring metric was established.…”

Section: Introductionmentioning

confidence: 99%

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Process for Delivering Timely Antibiotics to Febrile Bone Marrow Transplant Patients in the Emergency Department

Finefrock

Varughese

Ding

et al. 2021

JCO Oncology Practice

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PURPOSE: Patients with a history of a bone marrow transplant (BMT) have a higher risk of infectious complications because of an immunocompromised state. It has been shown that giving timely antibiotics in 1 hour or less from presentation to the emergency department (ED) decreases morbidity and mortality in this patient population. We hypothesize that a quality improvement (QI) process, termed BMT Fever, will improve timely administration of antibiotics for this population presenting to the ED. METHODS: This is a QI process designed to improve the administration of antibiotics to BMT patients with a subjective or objective fever presenting to the ED. The percent of patients receiving antibiotics within 1 hour or less was compared pre- and post-intervention. RESULTS: Upon implementation of the BMT Fever QI process, the percentage of patients with febrile BMT receiving antibiotics within 1 hour or less per fiscal quarter significantly improved from six out of 28 patients (21%) to 147 out of 173 patients (85%), P value < .05. CONCLUSION: By implementing a QI process that addresses five structural obstacles, we were able to improve our timely administration of antibiotics to patients with febrile BMT presenting to the ED.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Process for Delivering Timely Antibiotics to Febrile Bone Marrow Transplant Patients in the Emergency Department

Finefrock

Varughese

Ding

et al. 2021

JCO Oncology Practice

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“…La aparición de neutropenia asociada a episodios de fiebre en pacientes oncológicos que reciben quimioterapia se considera una emergencia, puesto que amenaza la vida del paciente y requiere atención inmediata 4,5 ; además resulta vital que la terapia con antibióticos de amplio espectro se inicie preferiblemente en la primera hora luego del comienzo de los síntomas [6][7][8] . La frecuencia de esta complicación es mayor en pacientes con malignidades hematológicas; se estima que alrededor del 80% de los casos de neutropenia febril se presentan en estos, en comparación con los pacientes que tienen tumores sólidos, en los que se cree que puede presentarse en un 10-15% 9 .…”

Section: Introductionunclassified

Neutropenia febril inducida por quimioterapia e infecciones asociadas: una revisión de la literatura

Thowinson-Hernández¹,

Hernández-Martínez²

2019

GAMO

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La neutropenia febril es una de las complicaciones más importantes de los pacientes oncológicos que reciben quimioterapia, mientras que las infecciones y la sepsis suelen ser los desenlaces más frecuentes e importantes de los pacientes que desarrollan esta condición debido a la alta tasa de mortalidad que representan. Por tanto, resulta importante el conocimiento de estos fenómenos y el impacto sobre la vida del paciente. En el presente manuscrito se hace una revisión de la literatura en las bases de datos de PubMed, seleccionando artículos actualizados y con información sobre la neutropenia febril, tanto en español como en inglés, y posteriormente se concluye que el poder identificar la neutropenia de manera oportuna y un tratamiento eficaz puede llevar a mejores desenlaces en los pacientes.

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Microbiological Spectrum of Infection-Related Febrile Episodes in Adult Patients With Hematologic Malignancies

Miradi

Sheybani

Sarvghad

et al. 2019

Infect Dis Clin Pract

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Background In recent years, antimicrobial resistance and the limited number of new antimicrobials under development have profoundly complicated treatment options especially in patients with hematologic malignancies that are treated with sequential courses of antimicrobial therapy. These issues emphasize on the importance of surveillance studies to monitor antimicrobial resistance and implement the antimicrobial stewardship strategies in health care centers. Methods The study was a prospective cohort with the aim of evaluating the microbiological spectrum of infection-related febrile episodes in adult patients with hematologic malignancies who admitted in a 1000-bed teaching hospital affiliated to Mashhad University of Medical Sciences, Iran. Results One hundred eight infection-related febrile episodes were identified in 108 individuals with hematologic malignancies of whom 18.5% had bacteremia. The most commonly isolated pathogens were coagulase-negative staphylococci (40%), followed by Escherichia coli (25%), and Klebsiella spp (10%), respectively. Carbapenems and glycopeptides were prescribed in the empirical regimen of 96.4% and 61.2% of patients. Although more than 67% of them needed to be deescalated at the second key time of antimicrobial therapy, it was performed only in 9%. Conclusions Our study highlighted the high rates of prescription of broad-spectrum antimicrobials in the empirical regimen of patients and a poor adherence to appropriate deescalation strategies after the second key time point of antimicrobial therapy among physicians in charge of patients with hematologic malignancies. It also emphasizes the importance of developing infrastructure for implementation and adherence to antimicrobial stewardship strategies in hematologic malignancy wards in developing countries such as Iran.

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A comparison of ED and direct admission care of cancer patients with febrile neutropenia

Cited by 8 publications

References 10 publications

Process for Delivering Timely Antibiotics to Febrile Bone Marrow Transplant Patients in the Emergency Department

Process for Delivering Timely Antibiotics to Febrile Bone Marrow Transplant Patients in the Emergency Department

Neutropenia febril inducida por quimioterapia e infecciones asociadas: una revisión de la literatura

Microbiological Spectrum of Infection-Related Febrile Episodes in Adult Patients With Hematologic Malignancies

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