نبذة مختصرة : Background:Febrile neutropenia (FN) is a common life threatening complication in haematology patients for which reducing time to antibiotics has been shown to improve outcomes. Previous studies have focused on reducing time to antibiotic administration in the outpatient population, however there is limited research from inpatient populations. Objective: The aim of this study was to investigate whether the implementation of a FN management pathway could reduce the time to antibiotics administration for inpatients with febrile neutropenia. Design:Prospective observational study from November 2012-October 2014. Settings:The Canberra Hospital, a tertiary referral centre. Participants:Haematology in patients with FN defined as an absolute neutrophil count of ≤1.0 x 109/L and temperature ≥38.0°C. Intervention:A FN management pathway which included medical registrar review within 30 minutes and empirical antibiotics administration within 60 minutes of fever detection. Main outcome measures: time from fever detection to antibiotic administration, ICU admission rates, mortality. Results:133 patient episodes of FN were included in the analysis, 58 prior to implementation of the management plan and 75 in the year following. Mean time to antibiotics improved from 242.8 minutes to 69.7 minutes (p=0.005). There was no significant difference in intensive care unit admission rates. Mortality improved from 8.3% to 1.3% with a trend towards statistical significance (p=0.11). Conclusion:Implementation of a FN management pathway effectively reduced the time to antibiotics in hematology inpatients with FN with a trend towards improved mortality.
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