학술논문

Early switch from intravenous to oral antibiotic therapy in patients with cancer who have low-risk neutropenic sepsis: the EASI-SWITCH RCT
Document Type
article
Source
Health Technology Assessment, Vol 28, Iss 14 (2024)
Subject
ambulatory care
amoxicillin-potassium clavulanate combination
ciprofloxacin
cost–benefit analysis
duration of therapy
febrile neutropenia
guideline adherence
health resources
patient preference
piperacillin
tazobactam drug combination
risk factors
sepsis
treatment failure
pragmatic clinical trials as topic
Medical technology
R855-855.5
Language
English
ISSN
2046-4924
Abstract
Background Neutropenic sepsis is a common complication of systemic anticancer treatment. There is variation in practice in timing of switch to oral antibiotics after commencement of empirical intravenous antibiotic therapy. Objectives To establish the clinical and cost effectiveness of early switch to oral antibiotics in patients with neutropenic sepsis at low risk of infective complications. Design A randomised, multicentre, open-label, allocation concealed, non-inferiority trial to establish the clinical and cost effectiveness of early oral switch in comparison to standard care. Setting Nineteen UK oncology centres. Participants Patients aged 16 years and over receiving systemic anticancer therapy with fever (≥ 38°C), or symptoms and signs of sepsis, and neutropenia (≤ 1.0 × 109/l) within 24 hours of randomisation, with a Multinational Association for Supportive Care in Cancer score of ≥ 21 and receiving intravenous piperacillin/tazobactam or meropenem for