Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 807, Hoguk-ro, Buk-gu, Daegu, Republic of Korea.
Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
Sci Rep. 2021 Sep 15;11(1):9048. doi: 10.1038/s41598-021-88207-6.
Although the clinical practice guideline for outpatient management of febrile neutropenia (FN) in adults treated for malignancy was updated by the ASCO/IDSA in 2018, most patients with FN in our hospital have been hospitalized. We performed this study to analyze the usefulness of the guideline. The medical records of patients hospitalized for FN in Kyungpook National University Chilgok Hospital from May 2016 to April 2018 were retrospectively reviewed. The feasibility of candidates for outpatient management according to the guideline was evaluated based on the outcomes. A total of 114 patients were enrolled and categorized into two groups, low-risk (38.6%) and high-risk (61.4%). The proportion of feasible candidates for outpatient management was 70.2% and was higher in the low-risk than in the high-risk group (90.0% vs. 57.1%; P < 0.001). The low-risk group had no mortality, no resistance to oral amoxicillin/clavulanate or ciprofloxacin, a higher rate of successful empirical antibiotics, and lower rates of glycopeptide or carbapenem administration. A significant number of hospitalized cancer patients treated for FN after chemotherapy were found to be feasible candidates for outpatient management. The guideline can be a useful tool to reduce labor of healthcare workers and hospitalization costs.
尽管 2018 年 ASCO/IDSA 更新了成人恶性肿瘤患者门诊发热性中性粒细胞减少症（FN）管理的临床实践指南，但我们医院的大多数 FN 患者仍住院治疗。我们进行这项研究是为了分析该指南的实用性。回顾性分析了 2016 年 5 月至 2018 年 4 月在庆北国立大学基尔戈德医院因 FN 住院的患者的病历。根据结局评估了根据指南门诊管理候选者的可行性。共纳入 114 例患者，分为低危（38.6%）和高危（61.4%）两组。门诊管理候选者的可行性比例为 70.2%，低危组高于高危组（90.0%比 57.1%；P<0.001）。低危组无死亡，无口服阿莫西林/克拉维酸或环丙沙星耐药，经验性抗生素治疗成功率更高，糖肽类或碳青霉烯类药物使用率更低。发现化疗后治疗 FN 的大量住院癌症患者是可行的门诊管理候选者。该指南可作为减少医护人员工作量和住院费用的有用工具。
