Background: Chemotherapy induced neutropenic fever can be safely treated with oral antibiotics. However, guidelines are based on studies that focused on patients with solid tumors.
Objective: To evaluate the effectiveness and safety of oral antibiotics in non-Hodgkin's lymphoma (NHL) patients with low risk neutropenic fever.
Methods: The files of all NHL patients who were hospitalized due to low risk neutropenic fever were reviewed. All patients who were hospitalized in our department were treated with oral amoxicillin - clavulanic acid and ciprofloxacin. Patients who were hospitalized in the other departments received parenteral antibiotics. The two modalities were compared for the course and outcome of the febrile disease.
Results: The files of 48 patients were reviewed. Most patients had intermediate grade NHL, stages III-IV. Thirty-three patients with 44 episodes of neutropenic fever were treated parenterally, while 15 patients with 19 episodes received oral antibiotics. The two policies had equally successful outcomes (59% in the parenteral group and 74% in the oral group, p=0.270). There was no difference in the rate of mortality, serious complications, secondary infections, no response to initial antibiotic regimen, and antibiotic regimen intolerance.
Conclusion: The study confirms that oral ciprofloxacin and amoxicillin - clavulanate is a valuable alternative to the parenteral treatment combination in the management of NHL patients with chemotherapy-induced low risk febrile neutropenia.