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La conducta clásica ante un episodio febril en un paciente neutropénico por quimioterapia ha consistido, durante años, en el ingreso hospitalario y la administración de antibioterapia empírica de amplio espectro por vía intravenosa. Sin embargo, desde finales de la década de los ochenta, se ha establecido que no todos los episodios de neutropenia comportan el mismo riesgo de complicaciones. Estos pacientes con fiebre y neutropenia de bajo riesgo, es decir, sin foco infeccioso claro, sin criterios de sepsis grave y con una duración esperada de la neutropenia inferior a 7-10 días, podrían beneficiarse de un tratamiento antibiótico ambulatorio por vía oral o, en su defecto, por vía intravenosa mediante bombas de perfusión en el propio domicilio del paciente.
En este trabajo se analiza la situación actual de estas nuevas modalidades de tratamiento, que tienen como objetivos mejorar la calidad de vida de los pacientes y optimizar los recursos y costes sanitarios.
Palabras clave:
Fiebre
Bajo riesgo
Tratamiento ambulatorio
Calidad de vida
For years the classical approach to febrile episodes in patients with chemotherapy-induced neutropenia consisted of hospital admission and intravenous administration of broad-spectrum antibiotics. However, since the end of the 1980s, it has been known that not all episodes of neutropenia carry the same risk of developing complications. These low risk febrile patients with neutropenia, that is, those without a clear focus of infection, without criteria for severe sepsis, and with an expected duration of neutropenia of less than 7-10 days, could benefit from outpatient oral antibiotic therapy or, failing this, from intravenous administration through a perfusion pump in the home.
The present study analyzes the current situation of the new treatment modalities that aim to improve patients’ quality of life and to optimize healthcare resources and costs.
Key words:
Fever
Low risk
Outpatient treatment
Quality of life
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