Early Hospital Discharge or Standard Inpatient Care in Cancer Patients Receiving Antibiotics for Febrile Neutropenia

• Status: Unknown status
• Trial end date: 1969-12-31
• Target enrollment: 0
• Participant gender: All

Summary

RATIONALE: Finishing an antibiotic regimen at home may be as effective as receiving it in the hospital. It is not yet known whether early hospital discharge is as effective as standard inpatient care in cancer patients receiving antibiotics for febrile neutropenia.

PURPOSE: This randomized phase III trial is studying early hospital discharge and comparing it with standard inpatient care in cancer patients receiving antibiotics for febrile neutropenia.

• Phase: Phase 3
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Clatterbridge Centre for Oncology
• Treatments: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotics, Antitubercular; Ciprofloxacin; Clavulanic Acid; Clavulanic Acids

Criteria

DISEASE CHARACTERISTICS:

• Diagnosis of solid tumor or lymphoma AND meets the following criteria:

• Low-risk patient, defined as Multinational Association for Supportive Care in Cancer prognostic index score ≥ 21

• Presents with neutropenic fever defined as follows:

• Absolute neutrophil count ≤ 500/mm³ OR < 1,000/mm³ but anticipated to fall to ≤ 500/mm³ within 24 hours of study entry

• Temperature ≥ 38.5°C on a single measurement or ≥ 38.0°C on > 1 occasion (one of which could be measured by the patient prior to admission) ≥ 1 hour apart

• Undergoing concurrent cytotoxic chemotherapy for treatment of solid tumors or lymphoma

• No leukemia

PATIENT CHARACTERISTICS:

• Compliant and appropriate for early discharge

• Able to read a thermometer (patient or caregiver)

• Able to tolerate oral medication

• Must have a responsible adult caregiver if eligible for early discharge

• No known allergy to oral antibiotics or penicillin

• No requirement for IV fluid support

• No central venous catheter-associated infection or evidence of infection not amenable to treatment by study antibiotics

• No neutropenic fever at high risk of complications

• No associated comorbidity that requires hospitalization and management

• No known HIV positivity

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics

• No prior participation in this study for neutropenic episode

• No prior bone marrow transplantation or peripheral blood stem cell transplantation

• No prior treatment for leukemia

• More than 72 hours since prior antibiotics, including prophylactic antibiotics

• Prophylactic septrin (for pneumocystis), acyclovir, or antifungals are allowed

• No concurrent granulocyte colony-stimulating factor therapy