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Impact of time to antibiotics on outcomes of chemotherapy-induced febrile neutropenia

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Abstract

Purpose

The aim of this study was to determine the relationship between the time to antibiotic administration and patients’ outcomes of febrile neutropenia (FN). We also investigated the relationship between the time to antibiotics and mortality rates in a subgroup of patients with bacteremia or severe sepsis or septic shock.

Methods

From the Neutropenic Fever Registry, we analyzed 1001 consecutive FN episodes diagnosed from November 1, 2011, to August 31, 2014. Timing cutoffs for antibiotics included the following: ≤1 vs. >1 h, ≤2 vs. >2 h, ≤3 vs. >3 h, and ≤4 vs. >4 h. Multivariate logistic regression was used to adjust for potential confounders in the association between timing intervals and outcomes of FN episodes.

Results

The median length of time from triage to antibiotics was 140 min (interquartile range, 110–180 min). At each time cutoff, the time from triage to antibiotic administration was not significantly associated with FN outcomes after adjusting for potential confounders. Antibiotic timing was not significantly associated with complication rates in overall FN episodes. We failed to find a significant relationship between antibiotic timing and mortality in FN episodes with severe sepsis or septic shock or with bacteremia. Procalcitonin concentration and the Multinational Association for Supportive Care in Cancer (MASCC) risk index score were found to be more crucial determinants of outcomes in patients with FN.

Conclusions

The time to antibiotic administration is not a major factor in FN outcomes.

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Conflict of interest

The authors declare that they have no conflicts of interest. We have full control of all primary data and agree to allow the journal to review the data if requested.

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Authors and Affiliations

  1. Department of Emergency Medicine, Cancer Emergency Room, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Songpa-gu, Seoul, 138-736, Korea

    Byuk Sung Ko, Shin Ahn, Yoon-Seon Lee, Won Young Kim & Kyung Soo Lim

  2. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jae-Lyun Lee

Authors
  1. Byuk Sung Ko
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  2. Shin Ahn
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  3. Yoon-Seon Lee
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  4. Won Young Kim
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  5. Kyung Soo Lim
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  6. Jae-Lyun Lee
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Correspondence to Shin Ahn.

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Ko, B.S., Ahn, S., Lee, YS. et al. Impact of time to antibiotics on outcomes of chemotherapy-induced febrile neutropenia. Support Care Cancer 23, 2799–2804 (2015). https://doi.org/10.1007/s00520-015-2645-5

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  • DOI: https://doi.org/10.1007/s00520-015-2645-5

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