Management of neutropenic fever in a private hospital oncology unit.

Intern Med J

Bendat Respiratory Research and Development Fund, St John of God Healthcare, Perth, Western Australia, Australia.

Published: August 2020

AI Article Synopsis

  • Neutropenic fever is a critical condition for cancer patients undergoing chemotherapy, requiring timely administration of IV antibiotics according to guidelines.
  • A study conducted at St John of God Hospital reviewed 98 admissions of 88 patients with neutropenic fever during 2017, revealing a median age of 64 years and identifying significant delays in antibiotic treatment.
  • While 89% of the antibiotic selections matched Australian guidelines, only 11% of patients received antibiotics within the recommended 60-minute window, prompting strategies to improve the speed of treatment initiation.

Article Abstract

Background: Neutropenic fever is a medical emergency, which poses a significant morbidity and mortality risk to cancer patients receiving chemotherapy. National guidelines recommend that patients presenting with suspected neutropenic fever receive appropriate intravenous antibiotics within 60 min of admission.

Aim: We aimed to investigate the management of neutropenic fever in a large private oncology centre.

Methods: A retrospective audit of all patients who presented to St John of God Hospital, Subiaco, in the 2017 calendar year, with a known solid organ malignancy and a recorded diagnosis of neutropenic fever was conducted. Patients were identified through the hospitals Patient Administration System and ICD-10 codes. Information was collected from the hospital medical records using a standardised data collection tool.

Results: There were 98 admissions relating to 88 patients with neutropenic fever during the study period. The median age was 64 years (range: 23-85 years) with 57 (65%) females. Antibiotic selections consistent with the Australian guidelines were made in 88 (89%) admissions. The mean time to antibiotic administration was 279 min, with a median of 135 min (range: 15-5160 min). Antibiotics were administered within the recommended time frame in only eight (11%) admissions.

Conclusion: Clinicians prescribed antibiotics in accordance with national guidelines; however, there were systemic inefficiencies which resulted in delayed antibiotic initiation. This has resulted in implementation of strategies to minimise delay.

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Source
http://dx.doi.org/10.1111/imj.14464DOI Listing

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