Management of Febrile Neutropenia in a Private Hospital Oncology Unit

AIM: Febrile neutropenia 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 febrile neutropenia receive appropriate intravenous antibiotics within 60 min of admission. We aimed to investigate the management of febrile neutropenia in a large private oncology centre. METHOD: 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 febrile neutropenia. 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 febrile neutropenia 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 admissions (89%). 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 resulting in delayed antibiotic initiation. This has resulted in implementation of strategies to minimise delay. This article is protected by copyright. All rights reserved.