A simple intervention to improve antibiotic treatment times for neutropenic sepsis

Botten, J.; Beard, Jessica H.; Zorzi, Antony; Thompson, Andrew

doi:10.52964/amja.0593

Cited by 3 publications

(4 citation statements)

References 4 publications

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“…We have also facilitated rapid antibiotic therapy on patient arrival via the use of the Neutropenic Sepsis Alert Card, meaning that on initial presentation and if a readmission is required patients can be treated with IV antibiotics rapidly. 15 The early goal directed treatment ensures antibiotics are given early in the patient journey and thus optimises patient safety.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with suspected neutropenic sepsis are treated with a STAT dose of IV antibiotics on arrival while investigations and assessment are undertaken. 15 Patients who have confirmed neutropenia (neutrophil count <1 x 10 9 /L) are then assessed using the MASCC score. Those who have a MASCC score ≥21 are considered for early-supported discharge depending on the following criteria:…”

Section: Methodsmentioning

confidence: 99%

“…On arrival the Sepsis 6 bundle is initiated and a stat dose of intravenous broad spectrum antibiotics is given prior to medical assessment. 15 Early Supported Discharge for patients with febrile neutropenia -Experience at a large district hospital in the UK This has been facilitated by the introduction locally of a Neutropenic Sepsis Alert Card. 15 The patients then have an assessment by the Medical and Acute Oncology Service (AOS) teams.…”

Section: Introductionmentioning

confidence: 99%

“…15 Early Supported Discharge for patients with febrile neutropenia -Experience at a large district hospital in the UK This has been facilitated by the introduction locally of a Neutropenic Sepsis Alert Card. 15 The patients then have an assessment by the Medical and Acute Oncology Service (AOS) teams. If the patient is found to be neutropenic, the MASCC score is calculated and this is used as a tool to aid decision making about early-supported discharge.…”

Section: Introductionmentioning

confidence: 99%

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Early Supported Discharge for patients with febrile neutropenia – Experience at a large district hospital in the UK

et al. 2019

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Neutropenic sepsis can be life threatening, with mortality 2-21%. The heterogeneity of patients referred with “suspected neutropenic sepsis” has led to strategies being developed to risk-stratify patients and identify those with a low risk of septic complications that could be managed in the outpatient setting, such as The Multinational Association for Supportive Care in Cancer score (MASCC). Outcomes for patients referred with suspected neutropenic sepsis were assessed before and after use of MASCC guided early-supported discharge. 50/123 (41%) patients over 24 months were eligible for early-supported discharge. 26/50 patients had same-day discharge, 14 had overnight admission, 8 stayed 2 nights and 2 stayed 3 nights. Patients received on average 2 follow-up telephone consultations. There were 5 readmissions (10%) and no adverse events. In comparison group; 8 patients over 3-months would have been suitable, potentially saving 40 bed-days. This shows MASCC guided early-supported discharge is safe and cost-effective.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early Supported Discharge for patients with febrile neutropenia – Experience at a large district hospital in the UK

et al. 2019

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Treatment of infections in cancer patients: an update from the neutropenia, infection and myelosuppression study group of the Multinational Association for Supportive Care in Cancer (MASCC)

Rapoport

Cooksley

Johnson

et al. 2021

Expert Review of Clinical Pharmacology

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Introduction: Patients with hematological and advanced solid malignancies have acquired immune dysfunction, often exacerbated by treatment, posing a significant risk for development of infections. These are often difficult to diagnose and poorly responsive to anti-infective therapy. This review evaluates the utility of current clinical and treatment guidelines, as well as recent and emerging innovative approaches and therapies, in the setting of management of infections in cancer patients.Areas Covered: These include causes of infection in cancer patients, management of patients with high-risk and low-risk febrile neutropenia, management of low-risk patients in an outpatient setting, the role of granulocyte colony-stimulating factor (G-CSF) in the prevention and treatment of neutropenia-related infections, management of lung infections in various clinical settings, and emerging challenges surrounding the risk of infection in cancer patients treated with novel treatments, including targeted therapies, and immunotherapies. The literature search was performed by accessing PubMed and other databases, focusing on published clinical trials of relevant anti-cancer agents and diseases. These primarily coveried the recent past, but also included several key studies published during the last decade and, somewhat earlier in a few cases.Expert Review: Notwithstanding the promise of gene therapy/gene editing in hematological malignancies and some types of solid cancers, innovations introduced in clinical practice include more discerning clinical management such as the generalized use of biosimilar formulations G-CSF and the implementation of novel, innovative immunotherapies.

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Improving door-to-needle times for patients with suspected neutropenic sepsis

Wild

2017

Emergency Nurse

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Neutropenic sepsis is a potentially life-threatening complication of chemotherapy and has an associated mortality of 2% to 21%. Patients can deteriorate rapidly and are usually advised to attend their local emergency department (ED) for urgent assessment and antibiotic therapy within one hour of arrival. Delivery of this emergency care is, however, inconsistent, and at times suboptimal, due to a lack of awareness of the condition and of clinical expertise. This article discusses a collaborative project between an acute oncology service and an ED, which has improved and sustained compliance with this standard through a range of initiatives, including revised and integrated sepsis guidelines, education, sepsis champions and a fast-track patient pathway. A transformational leadership approach, which embraced collaborative working and fostered motivation by creating ownership of the project by the ED team, has been instrumental in its success.

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A simple intervention to improve antibiotic treatment times for neutropenic sepsis

Cited by 3 publications

References 4 publications

Early Supported Discharge for patients with febrile neutropenia – Experience at a large district hospital in the UK

Early Supported Discharge for patients with febrile neutropenia – Experience at a large district hospital in the UK

Treatment of infections in cancer patients: an update from the neutropenia, infection and myelosuppression study group of the Multinational Association for Supportive Care in Cancer (MASCC)

Improving door-to-needle times for patients with suspected neutropenic sepsis

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