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Management of neutropenic fever in a private hospital oncology unit
Author(s) -
Skiba Rohen,
Sikotra Nisha,
Ball Timothy,
Arellano Astrid,
Gabbay Eli,
Clay Timothy D.
Publication year - 2020
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.14464
Subject(s) - medicine , medical record , neutropenia , antibiotics , emergency medicine , emergency department , febrile neutropenia , malignancy , intensive care medicine , chemotherapy , psychiatry , microbiology and biotechnology , biology
Background Neutropenic fever is a medical emergency, which poses a significant morbidity and mortality risk to cancer patients receiving chemotherapy. National guidelines recommend that patients presenting with suspected neutropenic fever receive appropriate intravenous antibiotics within 60 min of admission. Aim We aimed to investigate the management of neutropenic fever in a large private oncology centre. Methods A retrospective audit of all patients who presented to St John of God Hospital, Subiaco, in the 2017 calendar year, with a known solid organ malignancy and a recorded diagnosis of neutropenic fever was conducted. Patients were identified through the hospitals Patient Administration System and ICD‐10 codes. Information was collected from the hospital medical records using a standardised data collection tool. Results There were 98 admissions relating to 88 patients with neutropenic fever during the study period. The median age was 64 years (range: 23–85 years) with 57 (65%) females. Antibiotic selections consistent with the Australian guidelines were made in 88 (89%) admissions. The mean time to antibiotic administration was 279 min, with a median of 135 min (range: 15–5160 min). Antibiotics were administered within the recommended time frame in only eight (11%) admissions. Conclusion Clinicians prescribed antibiotics in accordance with national guidelines; however, there were systemic inefficiencies which resulted in delayed antibiotic initiation. This has resulted in implementation of strategies to minimise delay.