Ceftriaxone for the Treatment of Febrile Episodes in Nonneutropenic Patients with Hematooncological Disease or HIV Infection: Comparison of Outpatient and Inpatient Care

Abstract

Background: Patients with hematooncological disease or HIV infection and febrile episodes are usually treated in hospital with broad-spectrum antibiotics. The aim of this observational study was to assess the feasibility of ambulatory parenteral antibiotic therapy in hematooncological or HIV-infected patients with confirmed or suspected infection. Methods: The results in an outpatient treatment group were compared with those obtained in a group initially treated in hospital. Data were gathered on 90 outpatients and 72 inpatients. The inclusion criteria were fever ≧37.5°C with an identified focus of infection, fever ≧38.0°C of suspected bacterial origin with no identified focus of infection, leukocytosis ≧9,000/µl or C-reactive protein elevation ≧10 mg/l. Results: Eighty outpatients and 69 inpatients were evaluable. Treatment in the outpatient group was begun with ceftriaxone. This led to defervescence in 87.5% of cases. The mean treatment duration was 7.1 days. Comparison of results in the outpatients with those initially hospitalized for treatment showed similar success rates. The mean hospital stay in the latter group was 12.9 days. Conclusions: Ceftriaxone represents an effective treatment for outpatient management of febrile episodes in patients with hematooncological disease or HIV infection. Outpatient treatment is more cost-effective than inpatient care.

Health costs from hospitalization with H1N1 infection during the 2009–2010 influenza pandemic compared with non-H1N1 respiratory infections

“… 27 From a health system point of view, this misdiagnosis of influenza A (H1N1)/2009 may have led to the underestimation of other serious conditions. 28 For the same reason, a large number of patients is likely to have been unnecessarily treated with oseltamivir, resulting in not only unnecessary cost and patient exposure to the side effects of this agent but also overimplementation of infection control procedures in hospitals. 29 – 31 Taken together, these findings underline and partly explain the high cost associated with H1N1.…”