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01-09-2008 | Original ARticle

Oral moxifloxacin or intravenous ceftriaxone for the treatment of low-risk neutropenic fever in cancer patients suitable for early hospital discharge

Authors: Catherine Sebban, Sophie Dussart, Christine Fuhrmann, Hervé Ghesquieres, Isabelle Rodrigues, Lionel Geoffrois, Yves Devaux, Laurence Lancry, Giselle Chvetzoff, Thomas Bachelot, Maria Chelghoum, Pierre Biron

Published in: Supportive Care in Cancer | Issue 9/2008

Abstract

Goals of work

Patients with low-risk neutropenic fever as defined by the Multinational Association of Supportive Care in Cancer (MASCC) score might benefit from ambulatory treatment. Optimal management remains to be clearly defined, and new oral antibiotics need to be evaluated in this setting.

Materials and methods

Cancer patients with febrile neutropenia and a favorable MASCC score were randomized between oral moxifloxacin and intravenous ceftriaxone. All were fit for early hospital discharge. The global success rate was related to the efficacy of monotherapy, as well as to the success of ambulatory monitoring.

Main results

The trial was closed prematurely because of low accrual. Ninety-six patients were included (47 in the ceftriaxone arm and 49 in the moxifloxacin arm). A total of 65% were women, 30.2% had lymphoma, 34.4% had metastatic, and 35.4% had non-metastatic solid tumors. The success rates of home antibiotics were 73.9% and 79.2% for ceftriaxone and moxifloxacin, respectively. Seven patients were not discharged, and 14 required re-hospitalization. There were 17% of microbiologically documented infections that were, in most cases, susceptible to oral monotherapy.

Conclusions

These results suggest that MASCC is a valid and useful tool to select patients for ambulatory treatments and that oral moxifloxacin monotherapy is safe and effective for the outpatient treatment of cancer patients with low-risk neutropenic fever.

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Title: Oral moxifloxacin or intravenous ceftriaxone for the treatment of low-risk neutropenic fever in cancer patients suitable for early hospital discharge
Authors: Catherine Sebban
Sophie Dussart
Christine Fuhrmann
Hervé Ghesquieres
Isabelle Rodrigues
Lionel Geoffrois
Yves Devaux
Laurence Lancry
Giselle Chvetzoff
Thomas Bachelot
Maria Chelghoum
Pierre Biron
Publication date: 01-09-2008
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 9/2008
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-007-0383-z

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