Oral moxifloxacin for outpatient treatment of low-risk, febrile neutropenic patients

Rolston, Kenneth V. I.; Frisbee-Hume, Susan; Patel, Shreyaskumar; Manzullo, Ellen F.; Benjamin, Robert S.

doi:10.1007/s00520-009-0634-2

Cited by 31 publications

(17 citation statements)

References 27 publications

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“…The success rate of the treatment was 84% (63 of 75 episodes), and 71 of 75 episodes (95%) were resolved without hospitalization. Several studies evaluating the use of oral antibiotics in the outpatient management of low-risk FN have reported treatment success rates of 77-95% (10,(14)(15)(16)(17), which is consistent with the results of the present study.…”

Section: Discussionsupporting

confidence: 83%

Outpatient management without initial assessment for febrile patients undergoing adjuvant chemotherapy for breast cancer

Kimura

Tanaka

Iwamoto

et al. 2016

Molecular and Clinical Oncology

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Abstract. The purpose of this study was to retrospectively analyze the feasibility of outpatient management without initial assessment for febrile patients undergoing adjuvant chemotherapy for breast cancer. A total of 131 consecutive patients with breast cancer treated with adjuvant or neoadjuvant chemotherapy from 2011 to 2013 at Osaka Medical College Hospital (Osaka, Japan) were retrospectively reviewed. In the case of developing a fever (body temperature, ≥38˚C), the outpatients had been instructed to take previously prescribed oral antibiotics for 3 days without any initial assessment, and if no improvement had occurred by then, they were required to visit the hospital for examination and to undergo treatment based on the results of a risk assessment for complications. The primary aim of the present study was to assess the outcome of febrile episodes, while the secondary aim was to assess the incidence of febrile episodes, hospitalizations, and the type of chemotherapy. The 131 patients received 840 chemotherapy administrations. Fifty-five patients (42.0%) had a total of 75 febrile episodes after 840 chemotherapy administrations (8.9%). Treatment failure occurred in 12 of the 75 episodes (16.0%) in 11 of the 55 patients (20.0%). Only four episodes required hospitalization. Treatment success was achieved in 63 episodes (84.0%). In conclusion, the feasibility of outpatient management without initial assessment was evaluated in the present study for febrile patients undergoing adjuvant chemotherapy for breast cancer, and the outpatient strategy regimen may be safe and convenient for these patients.

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Section: Discussionsupporting

confidence: 83%

Outpatient management without initial assessment for febrile patients undergoing adjuvant chemotherapy for breast cancer

Kimura

Tanaka

Iwamoto

et al. 2016

Molecular and Clinical Oncology

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“…Outpatient management for adult cancer patients with low-risk febrile neutropenia includes the administration of oral antimicrobial agents, which is shown to be safe and effective in reducing fever and to compare favorably with hospital treatment 4 , 6 , 7 . Fluoroquinolone antibacterial agents are important clinical tools used for the prevention and management of infections in cancer patients with neutropenia 2 , 3 , 8 , 9 . Levofloxacin is a broad-spectrum antimicrobial agent of the fluoroquinolone drug class that has shown excellent tissue penetration 10 .…”

Section: Introductionmentioning

confidence: 99%

Once-daily, oral levofloxacin monotherapy for low-risk neutropenic fever in cancer patients

Zhou

Zhao

et al. 2015

Anti-Cancer Drugs

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This pilot study assesses the safety and efficacy of once-daily, oral levofloxacin monotherapy in Chinese patients with low-risk febrile neutropenia. In this prospective, single-arm, open-label, multicenter clinical trial, 46 adult Chinese patients with solid tumors and low-risk febrile neutropenia were included. Patients received oral levofloxacin monotherapy (500 mg orally/day) until day 12, followed by 7 days of follow-up (day 19). Body temperature was measured three times per day. On days 2, 3, 5–7, 9, 12, and 19, disease symptoms and vital signs were recorded, adverse drug reactions were assessed, and blood samples were collected to determine the whole-blood cell count and the absolute neutrophil count. Blood cultures and chest radiographs were performed simultaneously until negative results were found. Oral levofloxacin was effective and well tolerated in 97.6% of patients irrespective of the cancer type and cause of fever. Body temperature began to decline in 24.4, 68.3, and 90.2% of patients, respectively, at 12, 24, and 48 h after initiating levofloxacin therapy. On days 5 and 7, 95.1 and 97.6% of the patients had complete defervescence, respectively. The median time for absolute neutrophil count recovery to at least 1500/mm3 after initiation of treatment was 3 days. Only one patient reported mild diarrhea. This pilot study showed that oral levofloxacin quickly and effectively reduced fever, initiated neutrophil recovery, and was well tolerated in Chinese low-risk febrile neutropenic patients with solid tumors. Further study is needed to compare patient data of levofloxacin with the standard amoxicillin/ciprofloxacin protocol in this population for both safety and efficacy.

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“…Plusieurs études rétrospectives [7] et prospectives [4,15,19,25,29,32], souvent monocentriques et non randomisées, plaident en faveur d'une PEC à domicile des NF de faible risque.…”

Section: Retour à Domicile Précoceunclassified

“…Enfi n, quelques méta-analyses sont publiées mais, comme le soulignent les auteurs eux-mêmes, leur niveau de preuve ne peut être optimal du fait de nombreux biais [13,[29][30][31]. Malgré leurs limites, les méta-analyses vont également dans le sens d'une PEC à domicile possible de la NF de faible risque.…”

Section: Retour à Domicile Précoceunclassified

See 1 more Smart Citation

Prise en charge initiale de la neutropénie fébrile

Kamioner¹,

Aapro²,

Chèze³

et al. 2011

Oncologie

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Oral moxifloxacin for outpatient treatment of low-risk, febrile neutropenic patients

Abstract: Oral outpatient quinolone monotherapy for low-risk febrile neutropenic patients appears feasible and needs to be formally evaluated in large randomized clinical trials.

Cited by 31 publications

References 27 publications

Outpatient management without initial assessment for febrile patients undergoing adjuvant chemotherapy for breast cancer

Outpatient management without initial assessment for febrile patients undergoing adjuvant chemotherapy for breast cancer

Once-daily, oral levofloxacin monotherapy for low-risk neutropenic fever in cancer patients

Prise en charge initiale de la neutropénie fébrile

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