Safety and cost effectiveness of early hospital discharge of lower risk children with cancer admitted for fever and neutropenia

摘要: Background. Standard treatment for fever during periods of chemotherapy-induced neutropenia includes hospitalization and administration intravenous antibiotics until the patient is afebrile no longer neutropenic. This study prospectively evaluates safety cost-effectiveness early discharge selected low risk children before recovery from neutropenia. Methods. We studied 74 with cancer 131 consecutive admissions a period neutropenia. All patients initially were hospitalized received broad-spectrum antibiotics. Intravenous antibiotic therapy was discontinued, promptly discharged even if they had an absolute neutrophil count (ANC) less than 500 cells/mm3 as long afebrile, appeared clinically well, negative cultures, exhibited control local infection, showed hematologic evidence bone marrow recovery. Results. discontinued in 82 cases (63%) ANC to more cells/mm3, 78 immediately. None 70 while neutropenic but exhibiting rising at time developed recurrent required readmission. Thirty these improving localized infection when completed course oral home. The estimated mean savings hospital charges due $5058 per patient. Conclusions. Low who are treated appear well may have be safely irrespective ANC, their granulocyte rising. approach shortens stays results considerable cost savings.