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Journal of Antimicrobial Chemotherapy (1999) 43, 317-320
© 1999 The British Society for Antimicrobial Chemotherapy

Leading article

Outpatient therapy for febrile neutropenia: who, when and how?

Ömrüm Uzuna and Elias J. Anaissieb,*

a Hacettepe University School of Medicine, Department of Medicine, Section of Infectious Diseases, Ankara 06100, Turkey b University of Arkansas for Medical Sciences, Arkansas Cancer Research Center, 4301 West Markham MS 776, Little Rock, AR 72205, USA

Why outpatient therapy for fever during neutropenia?

The dramatic increase in the cost of healthcare has raised the pressure on providers to deliver more cost-effective care. The USA is currently spending more than US $1 trillion annually for healthcare, and hospital stay accounts for a sizable amount of the total cost. In an effort to reduce health expenditures, the USA government has established reimbursement policies that favour outpatient management of patients who were traditionally cared for in the hospital setting. Outpatient therapy has proved to be feasible and successful in a variety of circumstances, including the practice of infectious disease. This approach has led to the development of such concepts as `sequential therapy's and `home intravenous therapy's in some diseases such as osteomyelitis, infective endocarditis, urosepsis and others. 1 ,2 ,3 ,4

Intravenous antibiotic therapy given in the hospital setting has been the standard approach for the management of fever and neutropenia. This strategy resulted from the well-known mortality and morbidity . . . [Full Text of this Article]

Who is a candidate for outpatient therapy? The risk-adjusted approach

Is outpatient therapy for febrile neutropenia feasible and safe?

When and how to deliver outpatient therapy

Considerations for future studies

Notes

References


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