An Australian survey of clinical practices in management of neutropenic fever in adult cancer patients 2009

S Lingaratnam, M A Slavin, L Mileshkin, B Solomon, K Burbury, J F Seymour, R Sharma, B Koczwara, Sue W Kirsa, I D Davis, M Prince, J Szer, C Underhill, O Morrissey, K A Thursky

Research output: Contribution to journalArticleResearchpeer-review

19 Citations (Scopus)

Abstract

Background:  An abundance of new evidence regarding treatment strategies for neutropenic fever is likely to contribute to variability in practice across institutions and clinicians alike. Aims:  To describe current clinical practices in Australia, by surveying haematologists, oncologists and infectious diseases physicians involved in cancer care. Methods:  Clinician members from Australian professional associations, accounting for the vast majority of Australian cancer specialists, were invited to participate in an electronic survey, comprising of a clinical case-based questionnaire. Clinical practice areas explored were: use of risk-assessment and empiric antibiotic strategies across various treatment settings; use of anti-bacterial prophylaxis; and use of granulocyte-colony stimulating factors for established neutropenic fever and for secondary prophylaxis. Results:  A total of 252 clinicians returned responses (approximately 30% response rate). The majority (>70%) were representative of practices in public, major city, tertiary referral hospitals. Less than half of clinicians were aware of risk-assessment tools and less than quarter currently used ambulatory care strategies. If adequate resources were made available, more than 80% were willing to use risk-assessment tools and 60% more clinicians were likely to use ambulatory care strategies. Most clinicians prescribed dual therapy parenteral antibiotics, even for clinically stable patients (53% haematologists, 56% oncologists). Granulocyte-colony stimulating factor was used frequently as secondary prophylaxis in the breast cancer case (91%), follicular lymphoma case (59%) and non-small cell lung cancer case (31%). Fluoroquinolone prophylaxis was infrequently prescribed (19% oncologists, 30% haematologists). Conclusions:  Evidence–practice gaps were identified around the use of risk-assessment-based empiric therapy, and help to inform better clinical guidance.
Original languageEnglish
Pages (from-to)110-120
Number of pages11
JournalInternal Medicine Journal
Volume41
DOIs
Publication statusPublished - Jan 2011

Cite this

Lingaratnam, S., Slavin, M. A., Mileshkin, L., Solomon, B., Burbury, K., Seymour, J. F., ... Thursky, K. A. (2011). An Australian survey of clinical practices in management of neutropenic fever in adult cancer patients 2009. Internal Medicine Journal, 41, 110-120. https://doi.org/10.1111/j.1445-5994.2010.02342.x
Lingaratnam, S ; Slavin, M A ; Mileshkin, L ; Solomon, B ; Burbury, K ; Seymour, J F ; Sharma, R ; Koczwara, B ; Kirsa, Sue W ; Davis, I D ; Prince, M ; Szer, J ; Underhill, C ; Morrissey, O ; Thursky, K A. / An Australian survey of clinical practices in management of neutropenic fever in adult cancer patients 2009. In: Internal Medicine Journal. 2011 ; Vol. 41. pp. 110-120.
@article{b21a8abc28244209934e3f792c9cc043,
title = "An Australian survey of clinical practices in management of neutropenic fever in adult cancer patients 2009",
abstract = "Background:  An abundance of new evidence regarding treatment strategies for neutropenic fever is likely to contribute to variability in practice across institutions and clinicians alike. Aims:  To describe current clinical practices in Australia, by surveying haematologists, oncologists and infectious diseases physicians involved in cancer care. Methods:  Clinician members from Australian professional associations, accounting for the vast majority of Australian cancer specialists, were invited to participate in an electronic survey, comprising of a clinical case-based questionnaire. Clinical practice areas explored were: use of risk-assessment and empiric antibiotic strategies across various treatment settings; use of anti-bacterial prophylaxis; and use of granulocyte-colony stimulating factors for established neutropenic fever and for secondary prophylaxis. Results:  A total of 252 clinicians returned responses (approximately 30{\%} response rate). The majority (>70{\%}) were representative of practices in public, major city, tertiary referral hospitals. Less than half of clinicians were aware of risk-assessment tools and less than quarter currently used ambulatory care strategies. If adequate resources were made available, more than 80{\%} were willing to use risk-assessment tools and 60{\%} more clinicians were likely to use ambulatory care strategies. Most clinicians prescribed dual therapy parenteral antibiotics, even for clinically stable patients (53{\%} haematologists, 56{\%} oncologists). Granulocyte-colony stimulating factor was used frequently as secondary prophylaxis in the breast cancer case (91{\%}), follicular lymphoma case (59{\%}) and non-small cell lung cancer case (31{\%}). Fluoroquinolone prophylaxis was infrequently prescribed (19{\%} oncologists, 30{\%} haematologists). Conclusions:  Evidence–practice gaps were identified around the use of risk-assessment-based empiric therapy, and help to inform better clinical guidance.",
author = "S Lingaratnam and Slavin, {M A} and L Mileshkin and B Solomon and K Burbury and Seymour, {J F} and R Sharma and B Koczwara and Kirsa, {Sue W} and Davis, {I D} and M Prince and J Szer and C Underhill and O Morrissey and Thursky, {K A}",
year = "2011",
month = "1",
doi = "10.1111/j.1445-5994.2010.02342.x",
language = "English",
volume = "41",
pages = "110--120",
journal = "Internal Medicine Journal",
issn = "1444-0903",
publisher = "Wiley-Blackwell",

}

Lingaratnam, S, Slavin, MA, Mileshkin, L, Solomon, B, Burbury, K, Seymour, JF, Sharma, R, Koczwara, B, Kirsa, SW, Davis, ID, Prince, M, Szer, J, Underhill, C, Morrissey, O & Thursky, KA 2011, 'An Australian survey of clinical practices in management of neutropenic fever in adult cancer patients 2009', Internal Medicine Journal, vol. 41, pp. 110-120. https://doi.org/10.1111/j.1445-5994.2010.02342.x

An Australian survey of clinical practices in management of neutropenic fever in adult cancer patients 2009. / Lingaratnam, S; Slavin, M A; Mileshkin, L; Solomon, B; Burbury, K; Seymour, J F; Sharma, R; Koczwara, B; Kirsa, Sue W; Davis, I D; Prince, M; Szer, J; Underhill, C; Morrissey, O; Thursky, K A.

In: Internal Medicine Journal, Vol. 41, 01.2011, p. 110-120.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - An Australian survey of clinical practices in management of neutropenic fever in adult cancer patients 2009

AU - Lingaratnam, S

AU - Slavin, M A

AU - Mileshkin, L

AU - Solomon, B

AU - Burbury, K

AU - Seymour, J F

AU - Sharma, R

AU - Koczwara, B

AU - Kirsa, Sue W

AU - Davis, I D

AU - Prince, M

AU - Szer, J

AU - Underhill, C

AU - Morrissey, O

AU - Thursky, K A

PY - 2011/1

Y1 - 2011/1

N2 - Background:  An abundance of new evidence regarding treatment strategies for neutropenic fever is likely to contribute to variability in practice across institutions and clinicians alike. Aims:  To describe current clinical practices in Australia, by surveying haematologists, oncologists and infectious diseases physicians involved in cancer care. Methods:  Clinician members from Australian professional associations, accounting for the vast majority of Australian cancer specialists, were invited to participate in an electronic survey, comprising of a clinical case-based questionnaire. Clinical practice areas explored were: use of risk-assessment and empiric antibiotic strategies across various treatment settings; use of anti-bacterial prophylaxis; and use of granulocyte-colony stimulating factors for established neutropenic fever and for secondary prophylaxis. Results:  A total of 252 clinicians returned responses (approximately 30% response rate). The majority (>70%) were representative of practices in public, major city, tertiary referral hospitals. Less than half of clinicians were aware of risk-assessment tools and less than quarter currently used ambulatory care strategies. If adequate resources were made available, more than 80% were willing to use risk-assessment tools and 60% more clinicians were likely to use ambulatory care strategies. Most clinicians prescribed dual therapy parenteral antibiotics, even for clinically stable patients (53% haematologists, 56% oncologists). Granulocyte-colony stimulating factor was used frequently as secondary prophylaxis in the breast cancer case (91%), follicular lymphoma case (59%) and non-small cell lung cancer case (31%). Fluoroquinolone prophylaxis was infrequently prescribed (19% oncologists, 30% haematologists). Conclusions:  Evidence–practice gaps were identified around the use of risk-assessment-based empiric therapy, and help to inform better clinical guidance.

AB - Background:  An abundance of new evidence regarding treatment strategies for neutropenic fever is likely to contribute to variability in practice across institutions and clinicians alike. Aims:  To describe current clinical practices in Australia, by surveying haematologists, oncologists and infectious diseases physicians involved in cancer care. Methods:  Clinician members from Australian professional associations, accounting for the vast majority of Australian cancer specialists, were invited to participate in an electronic survey, comprising of a clinical case-based questionnaire. Clinical practice areas explored were: use of risk-assessment and empiric antibiotic strategies across various treatment settings; use of anti-bacterial prophylaxis; and use of granulocyte-colony stimulating factors for established neutropenic fever and for secondary prophylaxis. Results:  A total of 252 clinicians returned responses (approximately 30% response rate). The majority (>70%) were representative of practices in public, major city, tertiary referral hospitals. Less than half of clinicians were aware of risk-assessment tools and less than quarter currently used ambulatory care strategies. If adequate resources were made available, more than 80% were willing to use risk-assessment tools and 60% more clinicians were likely to use ambulatory care strategies. Most clinicians prescribed dual therapy parenteral antibiotics, even for clinically stable patients (53% haematologists, 56% oncologists). Granulocyte-colony stimulating factor was used frequently as secondary prophylaxis in the breast cancer case (91%), follicular lymphoma case (59%) and non-small cell lung cancer case (31%). Fluoroquinolone prophylaxis was infrequently prescribed (19% oncologists, 30% haematologists). Conclusions:  Evidence–practice gaps were identified around the use of risk-assessment-based empiric therapy, and help to inform better clinical guidance.

U2 - 10.1111/j.1445-5994.2010.02342.x

DO - 10.1111/j.1445-5994.2010.02342.x

M3 - Article

VL - 41

SP - 110

EP - 120

JO - Internal Medicine Journal

JF - Internal Medicine Journal

SN - 1444-0903

ER -