Management of infective complications in patients with advanced hematologic malignancies in home care.

Abstract:

:A home care service has been implemented at our center with the aim of offering domiciliary assistance to patients with hematologic malignancies in advanced phase. We report our experience concerning the home management of these patients in the setting of infective complications. Of 151 patients in home care, 70 (46%) developed a total of 109 febrile episodes, performance status and neutrophil count significantly affecting the incidence of infections. Fever was of unknown origin in 51% of cases and microbiologically and clinically documented infections accounted for 26 and 23% of the cases, respectively. Oral ciprofloxacin in patients not neutropenic and intravenous ceftriaxone plus amikacin in neutropenic patients was shown to be effective and suitable for empiric home antibacterial treatment; in fact, 65% of febrile episodes responded to the initial antibacterial therapy with a further 16% after modification. Overall, 19.3% of the infective episodes were fatal, the prognosis appearing to be similar to that usually observed in the same category of patients in an inpatient setting. Our experience appears to show that a home care program could be the option of choice for patients with advanced cancer even in the setting of infective complications. It could improve the quality of life of patients and of their families, and it could save these subjects the risk of developing infections by resistant nosocomial isolates.

journal_name

Leukemia

journal_title

Leukemia

authors

Girmenia C,Moleti ML,Cartoni C,Cedrone M,De Gregoris C,De Sanctis V,Giovannini M,Latagliata R,Niscola P,Romani C,Rondinelli MB,Tosti S,Mandelli F

doi

10.1038/sj.leu.2400851

subject

Has Abstract

pub_date

1997-11-01 00:00:00

pages

1807-12

issue

11

eissn

0887-6924

issn

1476-5551

journal_volume

11

pub_type

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