Antibiotic Timing Not a Significant Factor in Outcomes of Febrile Neutropenia

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No significant correlation was established between the time from antibiotic administration and febrile neutropenia (FN) outcomes or complication rates in overall FN cases, according to an article published online in the journal Supportive Care in Cancer.

The authors evaluated 1,001 consecutive FN cases (diagnosed between November 1, 2011 and August 31, 2014) from the Neutropenic Fever Registry.

Antibiotic timing cutoffs were established as less than or equal to 1 hour versus greater than 1 hour, less than or equal to 2 hours versus greater than 2 hours, less than or equal to 3 hours versus greater than 3 hours, and less than or equal to 4 hours versus greater than 4 hours.

Analysis determined the median length of time from triage to antibiotics administration was 140 minutes (interquartile range, 110 to 180 minutes).

Results showed the time from triage to antibiotics was not related to FN outcomes, after adjusting for potential confounders, for each time cutoff.

Furthermore, the time to antibiotic administration was not found to be significantly associated with mortality in FN episodes with bacteremia, severe sepsis, or septic shock.

The investigators noted procalcitonin concentration and the Multinational Association for Supportive Care in Cancer (MASCC) risk index score appeared to be more critical determinants of FN patient outcomes. 

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No significant correlation was established between the time from antibiotic administration and febrile neutropenia outcomes.
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.
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