Figure 2. Identification of Candidates for Outpatient Management
a
Assessment and confirmation of patient's logistic and
psychosocial supports
d
High risk: presence of clinical
judgement criteria (Table 1) or
MASCC score <21 (Table 2) or
Talcott's groups 1–3 (Table 3)
b,c
Candidate for inpatient
management
Low risk: absense of clinical judgment criteria
or MASCC score ≥21 or Talcott's group 4.
Consider outpatient management or CISNE
tool (Table 4) for "low risk" group with solid
tumors who have undergone mild to moderate
intensity chemotherapy and appear to be
clinically stable
CISNE score
1 to 2:
Candidate
for outpatient
management
CISNE score
≥3:
Candidate
for inpatient
management
Candidates for outpatient management
e
:
• Administer the first dose of empiric therapy in the clinic,
emergency room, or hospital department.
f
• Oral empiric therapy with a fluoroquinolone
(ciprofloxacin or levofloxacin) plus amoxicillin/
clavulanate (or plus clindamycin for those with a
penicillin allergy) is recommended.
g
• Patients should be observed for at least four hours
before discharge.
Assess level of risk for serious medical complications
associated with febrile neutropenia using clinical judgment
criteria (Table 1), or a validated risk assessment tools
(Tables 2,3,4).
Identification of Candidates for
Outpatient Management
