A Retrospective Study: When Should We Give Antibiotics to Patients with Febrile Neutropenia in the Emergency Department?

Abstract

Aim: Febrile neutropenia (FN) is considered to be one of the most important and potentially life-threatening oncologic diseases in theemergency department. Our study aimed to determine whether there is an effective time for decreasing the mortality at the end of thefirst month after antibiotic administration.Materials and Methods: This study was designed as a retrospective cohort study. The study population consisted of FN patients who hadmalignancy >18 years and were admitted to the university hospital between January 2002 and July 2014. A total of 645 patients wereincluded in the study. Of the patients, 322 patients were included in the analysis. The cut-off value for antibiotic administration wasdetermined as ≤6 hours vs >6 hours.Results: The median age was 54 years, and 173 (53.7%) of the patients were male. Hematological and lung malignancies were found mostfrequently (46.9%, 12.4%, respectively). The median value of antibiotic administration was 247 minutes, and the mortality rate at the endof the first month was 24.5%. In the logistic regression analysis, the probability of death at the end of the first month in patients who hadantibiotic administration >6 hours was found 2.436 times higher than the other group.Conclusion: As a result, we found that the administration of the first dose of antibiotics to f FN patients in the first 6 hours is effective inreducing mortality.