Delay in Time to Antibiotics Permissible for Inpatient Neutropenic Fever

MONDAY, Jan. 9, 2023 (HealthDay News) -- For patients with hematologic malignancy who develop inpatient neutropenic fever, delays in time to antibiotics do not significantly affect overall survival at 180 days, according to a study published in the January/February issue of the American Journal of Medical Quality.

Noting that expert consensus recommends that antipseudomonas antibiotics be administered within 60 minutes of detection of neutropenic fever, Jordan Villars, M.D., from Thomas Jefferson University in Philadelphia, and colleagues examined whether delays in time to antibiotics impact overall survival in patients with hematologic malignancies who developed inpatient neutropenic fever. Data were included for 187 de novo neutropenic fever cases categorized by time to antibiotics (less than one, one to two, two to three, three to four, and more than four hours).

The researchers found that time to antibiotics did not significantly affect overall survival at 180 days after neutropenic fever episode. Risk was found to be higher for patients with a Charleston Comorbidity Index ≥3 (hazard ratio, 2.728).

"Ultimately, this study's findings question the applicability of the 60-minute guideline when used in the inpatient setting, and recommends that patients' medical history and additional markers of inflammation be considered when assessing the severity of neutropenic fever cases," the authors write.

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