[Oral antibiotics for non-Hodgkin's lymphoma patients with low risk neutropenic fever--a comparative controlled...

Chemotherapy induced neutropenic fever can be safely treated with oral antibiotics. However, guidelines are based on studies that focused on patients with solid tumors.

To evaluate the effectiveness and safety of oral antibiotics in non-Hodgkin's lymphoma (NHL) patients with low risk neutropenic fever.

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.

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.

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.