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Purpose <p>There is currently a lack of evidence regarding antibiotic use for adult cancer patients presenting with non-neutropenic fever. This study evaluated broad-spectrum antibiotics use among adult cancer patients who presented to the Emergency Department (ED) with non-neutropenic fever or/and suspected infection.</p> Methods <p>A retrospective cohort study was completed that included adult patients with solid malignancies who presented to Juravinski Hospital ED with non-neutropenic fever or suspected infection from July 1 to December 31, 2020. The primary outcome was the proportion of patients who received one or more dose(s) of broad-spectrum antibiotics. Additionally, a multivariate logistic regression was completed to assess factors associated with an increased likelihood of clinicians prescribing broad-spectrum antibiotics.</p> Results <p>Of 275 patients analyzed, broad-spectrum intravenous antibiotics were used in 47% (109/230) of the cohort, and most of the time (78%) was the first antibiotic type given after arrival in ED. Age, gender, comorbidities, and receiving systemic treatment were not significantly associated with increased broad-spectrum antibiotic use. There were higher rates of broad-spectrum antibiotics prescribed to patients with stage IV cancer (OR 2.8, <i>p</i> = 0.002) and genitourinary cancer (OR 6.7, <i>p</i> &lt; 0.001).</p> Conclusion <p>In our single-center study, nearly half of adult cancer patients received broad-spectrum intravenous antibiotics. With a few exceptions, there was generally no consistent criteria on which clinician prescribes broad-spectrum antibiotics. These data suggest a need for quality improvement strategies to improve antibiotic stewardship for cancer patients presenting with non-neutropenic fever.</p>

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Use of broad-spectrum antibiotics in adult cancer patients presenting to emergency department with non-neutropenic fever and/or suspected infection

  • 期刊论文

  • 发表日期：

    2025年4月16日

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  • Yuchen Li,
  • Zainab Al Maqrashi,
  • Luna Jia Zhan,
  • Zeba Siddiqui,
  • Elaine Jin,
  • Peter M. Ellis

摘要

Purpose

There is currently a lack of evidence regarding antibiotic use for adult cancer patients presenting with non-neutropenic fever. This study evaluated broad-spectrum antibiotics use among adult cancer patients who presented to the Emergency Department (ED) with non-neutropenic fever or/and suspected infection.

Methods

A retrospective cohort study was completed that included adult patients with solid malignancies who presented to Juravinski Hospital ED with non-neutropenic fever or suspected infection from July 1 to December 31, 2020. The primary outcome was the proportion of patients who received one or more dose(s) of broad-spectrum antibiotics. Additionally, a multivariate logistic regression was completed to assess factors associated with an increased likelihood of clinicians prescribing broad-spectrum antibiotics.

Results

Of 275 patients analyzed, broad-spectrum intravenous antibiotics were used in 47% (109/230) of the cohort, and most of the time (78%) was the first antibiotic type given after arrival in ED. Age, gender, comorbidities, and receiving systemic treatment were not significantly associated with increased broad-spectrum antibiotic use. There were higher rates of broad-spectrum antibiotics prescribed to patients with stage IV cancer (OR 2.8, p = 0.002) and genitourinary cancer (OR 6.7, p < 0.001).

Conclusion

In our single-center study, nearly half of adult cancer patients received broad-spectrum intravenous antibiotics. With a few exceptions, there was generally no consistent criteria on which clinician prescribes broad-spectrum antibiotics. These data suggest a need for quality improvement strategies to improve antibiotic stewardship for cancer patients presenting with non-neutropenic fever.