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Outpatient Oral Antibiotics for Febrile Neutropenic Cancer Patients

Medical Oncology Department, Henri Becquerel Centre, Rouen, France

To the Editor:

The report of Klastersky et al¹ in the September 1, 2006, issue of the Journal of Clinical Oncology provides interesting data about oral antibiotics with early discharge from hospital in cancer patients with low-risk febrile neutropenia. Nevertheless, the authors reported a statistically different response rate between early discharged patients and those who remained hospitalized. It is questionable whether this result can be relevant, as patients discharged after 24 hours were clinically stable or improving, meaning that patients remaining hospitalized were not. Also, with regards to the low number of documented infections in cancer patients with low-risk febrile neutropenia, it is debatable whether the end point of studies testing oral and/or hospital discharge should not be the failure rate of treatment rather than the success.^2,3 This would probably result in the need for studies with a larger number of patients. Therefore, conclusions would be more relevant, as the risk of oral/outpatients antibiotics for chemotherapy-induced febrile neutropenia is the failure of treatment.

Authors' Disclosures of Potential Conflicts of Interest

The authors indicated no potential conflicts of interest.

REFERENCES

1. Klastersky J, Paesmans M, Georgala A, et al: Outpatient oral antibiotics for febrile neutropenic cancer patients using a score predictive for complications. J Clin Oncol 24:4129-4134, 2006[Abstract/Free Full Text]

2. Finberg RW, Talcott JA: Fever and neutropenia: How to use a new treatment strategy. N Engl J Med 341:362-363, 1999[Free Full Text]

3. Vidal L, Paul M, Ben-Dor I, et al: Oral versus intravenous antibiotic treatment for febrile neutropenia in cancer patients: A systematic review and meta-analysis of randomized trials. J Antimicrob Chemother 54:29-37, 2004[Abstract/Free Full Text]

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This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ouvrier, M.-J. Articles by Blot, E. Search for Related Content PubMed PubMed Citation Articles by Ouvrier, M.-J. Articles by Blot, E. Social Bookmarking                            What's this?