Impact of Door to Needle Time of Antibiotics Administration on Outcome in Cancer Patients with Febrile Neutropenia

Objective: To determine the outcome of the door-to-needle time of antibiotics in cancer patients with febrile neutropenia. Methodology: It was a prospective cross-sectional study conducted at the emergency department of Shaukat Khanum Memorial Hospital Peshawar from April 2023 to December 2023. All the patients presenting to the emergency room with fever and a history of diagnosed malignancy, who received chemotherapy in the past 14 days and confirmed febrile neutropenia (fever>100 F and absolute neutrophil count of <500 cells/microliter) were included. Patients younger than 18 years of age were excluded. Data was analyzed through SPSS 24.0. A P value less than 0.05 was considered significant. Results: A total of 79 patients fulfilled the eligibility criteria. Most were males, i.e., 52 (65.8%). The mean age of patients was 51.71 ±9.8 years. The most common malignancy was lymphoma (25.3%), followed by sarcoma (12.6%) and breast cancer (11.3%). The mean duration of stay was 4.2±3.2 days. The mean MASCC score was 17.6 ±1.76. Sixty-two (78.5%) patients received antibiotics within one hour of arrival at the emergency room. Only two patients died during a hospital stay. A significantly increased number of admissions to the intensive care unit, length of hospital stay, and escalating antibiotic use were observed in patients who did not receive antibiotics within one hour of arrival compared to the other group. No statistically significant difference was noted in-hospital deaths among both groups. Conclusion: Timely antibiotics significantly lowered intensive care admissions and length of hospital stay. However, our study did not find its impact on in-hospital deaths.