Skip to main content

Outpatient Management of Neutropenic Fever: Antibiotics, Growth Factors or Both?

  • Chapter
Clinical Applications of Cytokines and Growth Factors

Part of the book series: Developments in Oncology ((DION,volume 80))

  • 114 Accesses

Abstract

The association of neutropenia and infection in patients with cancer receiving myelosuppressive chemotherapy was established over three decades ago by Bodey et al, who demonstrated that the risk of infection began to increase as the neutrophil count fell below 1000/mm3 and was greatest at levels below 100/mm3 (Figure 1)1.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bodey GP, Buckley M, Sathe YS, Freireich EJ. Quantitative relationships between circulating leukocytes and infections in patients with actue leukemia. Ann Intern Med 64:328–339, 1966.

    PubMed  CAS  Google Scholar 

  2. Meunier F. “Infections in patients with acute leukemia and lymphoma.” In Principles and Practice of Infectious Diseases, GL Mandell, RG Douglas Jr., JE Bennett, eds. New York: Churchill Livingstone, 1990.

    Google Scholar 

  3. Iezzoni, Lisa, ed. Risk Adjustment For Measuring Health Care Outcomes. Ann Arbor, Michigan: Health Administration Press, 1994.

    Google Scholar 

  4. Talcott JA, Finberg R, Mayer RJ, Goldman L. The medical course of cancer patients with fever and neutropenia. Arch Intern Med 148:2561–8, 1988

    Article  PubMed  CAS  Google Scholar 

  5. Talcott JA, Siegel RD, Finberg R, Goldman L. Risk assessment in cancer patients with fever and neutropenia: a prospective, two-center validation of a prediction rule. J Clin Oncol 10:316–22., 1992

    PubMed  CAS  Google Scholar 

  6. Talcott JA, Whalen A, Clark J, et al. Home antibiotic therapy for low-risk cancer patients with fever and neutropenia: a pilot study of 30 patients based on a validated prediction rule. J Clin Oncol 12:107–114, 1994

    PubMed  CAS  Google Scholar 

  7. Pizzo PA, Hawthorn JW, Hiemenz J, et al. A randomized trial comparing ceftazidime alone with combination antibiotic therapy in cancer patients with fever and neutropenia. New Engl J Med 315:552–558, 1986

    Article  PubMed  CAS  Google Scholar 

  8. Winston DJ, Ho WG, Brucker DA, et al. Controlled trials of double beta-lactam therapy with cefoperazone plus piperacillin in febrile granulocytopenic patients. Am J Med 85(Suppl):21–30, 1988

    Article  PubMed  CAS  Google Scholar 

  9. Bodey GP, Fainstein V, Elting LS, et al. Beta-lactam regimens for the febrile neutropenic patient. Cancer 65:9–16, 1990

    Article  PubMed  CAS  Google Scholar 

  10. Rolston KV, Berkey P, Bodey GP, et al. A comparison of imipenem to ceftazidime with or without amikacin as empiric therapy in febrile neutropenic patients. Arch Intern Med 152:283–91, 1992

    Article  PubMed  CAS  Google Scholar 

  11. Pizzo PA, Robichaud KJ, Gill FA, Witebsky FG. Empiric antibiotic and antifungal therapy for cancer patients with prolonged fever and granulocytopenia. Am J Med 72:101–11, 1982

    Article  PubMed  CAS  Google Scholar 

  12. Schimpff S, Satterlee W, Young VM, Serpick A. Empiric therapy with carbenicillin and gentamicin for febrile patients with cancer and granulocytopenia. New Engl J Med 284:1061–1065, 1971

    Article  PubMed  CAS  Google Scholar 

  13. Rubin M, Hathorn JW, Pizzo PA. Controversies in the management of febrile neutropenic cancer patients. Cancer Invest 6:167–184, 1988

    Article  PubMed  CAS  Google Scholar 

  14. DePauw BE, Dereskinski SC, Feld R, et al. Ceftazidime compared with piperacillin and tobramycin for the empiric treatment of fever in neutropenic patients with cancer: a multicenter randomized trial. Ann Intern Med 120:834–44, 1994.

    CAS  Google Scholar 

  15. Anaissie E, Fainstein V, Bodey GP, et al. Randomized trial of beta-lactam regimens in febrile neutropenic cancer patients. Am J Med 84:581–589, 1988.

    Article  PubMed  CAS  Google Scholar 

  16. Pizzo PA, Robichaud KJ, Gill FA, et al. Duration of empiric antibiotic therapy in granulocytopenic patients with cancer. Am J Med 1979 67:194–200.

    Article  PubMed  CAS  Google Scholar 

  17. Bodey GP. Overview of the problem of infections in the immunocompromised host. Am J Med 79 (suppl):56–61, 1985.

    Article  PubMed  CAS  Google Scholar 

  18. Rolston KVI, Bodey GP. “Infections in patients with cancer.” In Cancer Medicine, JF Holland, E Frei, RC Bast, DW Kufe, DL Morton, RR Weichselbaum, eds. Philadelphia, PA: Lea & Febiger, 1993.

    Google Scholar 

  19. Schimpff SC. “Infections in cancer patients — diagnosis, prevention, and treatment.” In Principals and Practice of Infectious Diseases, GL Mandell, JE Bennett, R Dolin, eds. New York: Churchill Livingstone, 1995.

    Google Scholar 

  20. Gardembas-Pain M, Desablens B, Sensebe L, et al. Home treatment of febrile neutropenia: an empirical oral antibiotic regimen. Ann Onc 2:485–7, 1991.

    CAS  Google Scholar 

  21. Malik IA, Khan WA, Aziz Z, Karim M. Self-administered antibiotic therapy for chemotherapy-induced, low-risk febrile neutropenia in patients with nonhematologic neoplasms. Clin Infect Dis 19:522–527, 1994.

    Article  PubMed  CAS  Google Scholar 

  22. Rubenstein EB, Rolston K, Benjamin RS, et al. Outpatient treatment of febrile episodes in low-risk neutropenic patients with cancer. Cancer 71(11):3640–3646, 1993.

    Article  PubMed  CAS  Google Scholar 

  23. Rolston KVI, Rubenstein EB, Elting L, et al. Ambulatory management of febrile episodes in low-risk neutropenic patients (abstract 2235). In Programs and Abstracts of the 35th Interscience Conference of Antimicrobial Agents and Chemotherapy 1995, San Francisco, CA, p. 333.

    Google Scholar 

  24. Rolston KVI, Rubenstein EB, Freifeld A. Early empiric antibiotic therapy for febrile neutropenia patients at low risk. Infectious Disease Clinics of North America 10(2):223–237, 1996.

    Article  PubMed  CAS  Google Scholar 

  25. Lau RC, King SM, Richardson SE. Early discharge of pediatric febrile neutropenic cancer patients by substitution of oral for intravenous antibiotics. Pediatric Hem Oncol 11:417–21, 1994.

    Article  CAS  Google Scholar 

  26. Bash RO, Katz JA, Cash JV, et al. Safety and cost effectiveness of early discharge of relatively low risk children with cancer hospitalized for fever and neutropenia (F/N). In Proceedings American Society Clinical Oncoly 11:381 (abstract), 1992.

    Google Scholar 

  27. Pettengell R, Gurney H, Radford JA, et al. Granulocyte colony-stimulating factor to prevent dose-limiting neutropenia in non-Hodgkin’s lymphoma: a randomized controlled trial. Blood 80(6): 1430–1436, 1992.

    PubMed  CAS  Google Scholar 

  28. Gerhartz HH, Stern AC, Wolf-Hornung B, et al. Intervention treatment of established neutropenia with human recombinant granulocyte-macrophage colony-stimulating factor (rhGM-CSF) in patients undergoing cancer chemotherapy. Leukemia Research 17(2): 175–185, 1993.

    Article  PubMed  CAS  Google Scholar 

  29. Trillet-Lenoir V, Green J, Manegold C, et al. Recombinant granulocyte colony stimulating factor reduces the infectious complications of cytotoxic chemotherapy. Eur J Cancer 29A(3):319–324, 1993.

    Article  PubMed  CAS  Google Scholar 

  30. Crawford J, Ozer H, Stoller R, et al. Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer. Clin Infect Dis 18(Suppl 2):S 189–96, 1994.

    Article  Google Scholar 

  31. Mayordomo JI et al. Improving treatment of chemotherapy-induced neutropenic fever by administration of colony-stimulating factors. J Natl Cancer Inst 87:803–808, 1995.

    Article  PubMed  CAS  Google Scholar 

  32. Maher DW et al. Filgrastim in patients with chemotherapy-induced febrile neutropenia: a double-blind, placebo-controlled trial. Ann Intern Med 1994 121:492–501, 1995.

    Google Scholar 

  33. Avilés A, Guzmán R, García EL, et al. Results of a randomized trial of granulocyte colony-stimulating factor in patients with infection and severe granulocytopenia. Anti-Cancer Drugs 7:392–397, 1996.

    Article  PubMed  Google Scholar 

  34. Elting LS, Rubenstein EB, Rolston KVI, Bodey GP. Outcomes of bacteremia in neutropenic cancer patients: observations from two decades of epidemiologic and clinical trials. Clin Infect Dis 25(2):247–259, 1997.

    Article  PubMed  CAS  Google Scholar 

  35. Mitchell PLR, Morland B, Stevens MCG, et al. Granulocyte colony-stimulating factor in established febrile neutropenia: a randomized study of pediatric patients. J Clin Oncol 15(3): 1163–1170, 1997.

    PubMed  CAS  Google Scholar 

  36. Elting LS, Rubenstein EB, Rolston K, Bodey GP. Correlation between antibiotic regimen and duration of fever in gram negative bacteremias (GNB). 7th International Symposium Supportive Care in Cancer 1995 September 20–23 Luxembourg.

    Google Scholar 

  37. Anaissie EJ, Vartivarian S, Bodey GP, et al. Randomized comparison between antibiotics alone and antibiotics plus granulocyte-macrophage colony-stimulating factor (Escherichia coli-derived) in cancer patients with fever and neutropenia. Am J Med 100:17–23, 1996.

    Article  PubMed  CAS  Google Scholar 

  38. American Society of Clinical Oncology. American Society of Clinical Oncology recommendations for the use of hematopoietic colony-stimulating factors: evidence-based, clinical practice guidelines. J Clin Oncol 12:2471–2508, 1994.

    Google Scholar 

  39. Gilbert C, Meisenberg B, Vredenburgh J, et al. Sequential prophylactic oral and empiric once-daily parenteral antibiotics for neutropenia and fever after high-dose chemotherapy and autologous bone marrow support. J Clin Conol 12:1005–1011, 1994.

    CAS  Google Scholar 

  40. Lyman GH, Lyman CG, Sanderson RA, Balducci L. Decision analysis of hematopoietic growth factor use in patients receiving cancer chemotherapy. J Natl Cancer Inst 85:488–493, 1993.

    Article  PubMed  CAS  Google Scholar 

  41. J. Klastersky for MASCC. Prognostic factors for outcome in cancer patients with febrile neutropenia: a multinational survey from the infection committee of the Multinational Association for Supportive Care in Cancer. In Program Proceedings American Society Clinical Oncology Vol 17:419A (abstract # 1617) May 16–19; Los Angeles, CA, 1998.

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer Science+Business Media New York

About this chapter

Cite this chapter

Rubenstein, E.B., Elting, L.S., Sun, C.C., Rolston, K.V.I. (1999). Outpatient Management of Neutropenic Fever: Antibiotics, Growth Factors or Both?. In: Wingard, J.R., Demetri, G.D. (eds) Clinical Applications of Cytokines and Growth Factors. Developments in Oncology, vol 80. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5013-6_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-5013-6_8

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7277-6

  • Online ISBN: 978-1-4615-5013-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics