Ceftriaxone for the treatment of febrile episodes in nonneutropenic patients with hematooncological disease or HIV infection:: Comparison of outpatient and inpatient care

Background: Patients with hematooncological disease or HIV infection and febrile episodes are usually treated in hospital with broad-spectrum antibiotics. The aim of this observational study was to assess the feasibility of ambulatory parenteral antibiotic therapy in hematooncological or HIV-infected patients with confirmed or suspected infection. Methods: The results in an outpatient treatment group were compared with those obtained in a group initially treated in hospital. Data were gathered on 90 outpatients and 72 inpatients. The inclusion criteria were fever greater than or equal to 37.5 degreesC with an identified focus of infection, fever greater than or equal to 38.0 degreesC of suspected bacterial origin with no identified focus of infection, leukocytosis greater than or equal to9,000/mul or C-reactive protein elevation greater than or equal to 10 mg/l. Results: Eighty outpatients and 69 inpatients were evaluable. Treatment in the outpatient group was begun with ceftriaxone. This led to defervescence in 87.5% of cases. The mean treatment duration was 7.1 days. Comparison of results in the outpatients with those initially hospitalized for treatment showed similar success rates. The mean hospital stay in the latter group was 12.9 days. Conclusions: Ceftriaxone represents an effective treatment for outpatient management of febrile episodes in patients with hematooncological disease or HIV infection. Outpatient treatment is more cost-effective than inpatient care. Copyright (C) 2001 S. Karger AG, Basel.