Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update

Resource type
Journal Article
Authors/contributors
Title
Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update
Abstract
PurposeTo provide an updated joint ASCO/Infectious Diseases Society of American (IDSA) guideline on outpatient management of fever and neutropenia in patients with cancer.MethodsASCO and IDSA convened an Update Expert Panel and conducted a systematic review of relevant studies. The guideline recommendations were based on the review of evidence by the Expert Panel.ResultsSix new or updated meta-analyses and six new primary studies were added to the updated systematic review.RecommendationClinical judgment is recommended when determining which patients are candidates for outpatient management, using clinical criteria or a validated tool such as the Multinational Association of Support Care in Cancer risk index. In addition, psychosocial and logistic considerations are outlined within the guideline. The panel continued to endorse consensus recommendations from the previous version of this guideline that patients with febrile neutropenia receive initial doses of empirical antibacterial therapy within 1 hour of triage and be monitored for ≥ 4 hours before discharge. An oral fluoroquinolone plus amoxicillin/clavulanate (or clindamycin, if penicillin allergic) is recommended as empirical outpatient therapy, unless fluoroquinolone prophylaxis was used before fever developed. Patients who do not defervesce after 2 to 3 days of an initial, empirical, broad-spectrum antibiotic regimen should be re-evaluated and considered as candidates for inpatient treatment.Additional information is available at www.asco.org/supportive-care-guidelines and www.asco.org/guidelineswiki.
Publication
Journal of Clinical Oncology
Date
February 20, 2018
Volume
36
Issue
14
Pages
1443-1453
Journal Abbr
JCO
Accessed
3/22/19, 5:14 PM
ISSN
0732-183X
Short Title
Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy
Library Catalog
ascopubs.org (Atypon)
Citation
Taplitz, R. A., Kennedy, E. B., Bow, E. J., Crews, J., Gleason, C., Hawley, D. K., Langston, A. A., Nastoupil, L. J., Rajotte, M., Rolston, K., Strasfeld, L., & Flowers, C. R. (2018). Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update. Journal of Clinical Oncology, 36(14), 1443–1453. https://doi.org/10.1200/JCO.2017.77.6211
GUIDELINES
HEME-ONC AND CELLULAR THERAPIES
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