The effect of time to antibiotics administration in febril neutropenia patients who admitted to emergency department on mortality, infection development and hospital length of stay

AIM: Our study's primary objective is to assess antibiotic administration time in patients with febrile neutropenia's effect on mortality on the first, third and sixth months after the antibiotic initiation. Additionally, correlation between antibiotic administration time, hospital length of stay and primary infection source were observed. Our secondary objective was to assess mortality risk correlation between demographic characteristics like; age, gender, seasonal hospitalization difference, culture sample withdrawal and bacterial growth status, co-morbidities and, primary infection source, the last chemotherapy/radiotherapy time, filgrastim use, ant biotherapy protocols and hematologic/solid tumors. METHODS: This study was designed as a retrospective cohort study. Our patient population included the patients whom registered to Akdeniz School of Medicine Emergency Department between January 2002 and June 2014 with febrile neutropenia older than 18 years of age. No sampling was done and a total of 645 patients were admitted to the study. 323 patients were excluded from study. Attendance to the study percentage was 51 %. A total of 322 patients are admitted into the study. RESULTS:The median age of FEN patients was 54. Mortality rate at the end of 1st month for FEN patients was significantly in patient group whose emergency department triage admittance and antibiotic administration time more than 6 hours when compared to the patient group whose emergency department triage admittance and antibiotic administration time less than 6 hours. In logistic regresion analyses the probability of death after 1 month in the patients who received antibiotics in after 6 hours was 2.436 compared to those who received antibiotics within 6 hours. In our study, in order to find an efficient time frame to reduce mortality after 1st month, ROC analysis is used. However, the area under the ROC curve demonstrating the correlation between antibiotic administration time and survival after 1st months was 0,508 and antibiotic administration time failed to show predicting survival after 1st month. Antibiotic administration time did not affect primary infection source and length of hospital stay (p>0,05). CONCLUSION: In conclusion, timely recognition of FEN patients whose emergency department triage admittance and rapid administration of first dose antibiotics to the possible source of infectionwithin the first 6 hours are effective in reducing mortality Keywords:Febrile neutropenia, mortality, time to antibiotic administration