1. Early switch from intravenous to oral antibiotic therapy in patients with cancer who have low-risk neutropenic sepsis: the EASI-SWITCH RCT
- Author
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Vicky Coyle, Caroline Forde, Richard Adams, Ashley Agus, Rosemary Barnes, Ian Chau, Mike Clarke, Annmarie Doran, Margaret Grayson, Danny McAuley, Cliona McDowell, Glenn Phair, Ruth Plummer, Dawn Storey, Anne Thomas, Richard Wilson, and Ronan McMullan
- Subjects
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 - 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
- Published
- 2024
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