Introduction to the Australian consensus guidelines for the management of neutropenic fever in adult cancer patients, 2010/2011

Authors


  • Funding: These guidelines were developed independently through funding from Victorian Integrated Cancer Services. The Western and Central Melbourne Integrated Cancer Service (WCMICS), one of three metropolitan and five regional Integrated Cancer Services funded by the Victorian Department of Human Services to implement the Victorian Government's Cancer Services Framework across Victoria, administered this funding.

  • Conflicts of interest: The following working group members are consultants or advisory committee members or receive honoraria, fees for service, or travel assistance (independent of research-related meetings) from; or have research or other associations with the organizations listed: Ian Davis – Novartis, Pfizer, GlaxoSmithKline, Schering-Plough; Andrew Grigg – Amgen, Gilead, Merck Sharp & Dohme, Novartis, Pfizer, Schering Plough, Sue Kirsa – Roche, Schering Plough, Amgen, Hospira, Alphapharm; Senthil Lingaratnam – Victorian Integrated Cancer Services; Orla Morrissey – Gilead, Merck Sharp & Dohme, Orphan, Pfizer, Schering Plough; William Renwick – Roche; Monica Slavin – Gilead, Merck Sharp & Dohme, Pfizer, Schering Plough; Brian Stein – Merck-Serono; Constantine Tam – GSK, Roche; Karin Thursky – Gilead, Merck Sharp & Dohme, Pfizer, Schering Plough; Andrew Wei – Celgene, Hospira, Novartis.

  • Steering committee
    Craig Bennett, Ian Davis, Sue Kirsa, Bogda Koczwara, Linda Mileshkin, Orla Morrissey, Mary O'Reilly, Miles Prince, John Seymour, Monica Slavin, Jeff Szer, Karin Thursky, Craig Underhill

  • Working group chairs
    Leon Worth, Chair (ambulatory strategies)
    Constantine Tam, Chair (empiric treatment)
    Monica Slavin, Chair (antibacterial prophylaxis)
    Andrew Grigg, Chair (granulocyte colony-stimulating factors)
    On behalf of the Neutropenic Fever Guidelines Working Group

  • Neutropenic fever guidelines working group
    David Andresen, BSc, MB BS, DTM&H, M.Medical.Sci (Clin Epi), FRACP (Infectious Diseases), FRCPA (Microbiology), Medical Microbiologist, Department of Infectious Diseases and Microbiology and Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW.
    Dr Patricia A Bastick, BMedSci, MB BS(Hons), FRACP, Staff Specialist Medical Oncology, St George and Sutherland Hospitals, Sydney, NSW; Conjoint Associate Lecturer, University of NSW.
    Mr Craig A Bennett, MSc (Health Econ), BEcon (Hons), FCHSE, Chief Executive Officer, Peter MacCallum Cancer Centre, East Melbourne, VIC.
    Ms Diana L Booth, M Clin Pharm, BMT Pharmacist, Royal Melbourne Hospital, Parkville, VIC.
    Dr Kate Burbury, MB BS, FRACP, FRCPA, Haematology Fellow, Peter MacCallum Cancer Centre, East Melbourne, VIC.
    Mr Michael J Cain, B Pharm, Senior Pharmacist (Oncology), Sir Charles Gardiner Hospital, Perth, WA.
    Dr Julian Cooney, MB BS, DipRACOG, FRACP, FRCPA, Clinical Haematologist, Royal Perth Hospital, Perth, WA.
    Associate Professor Ian D Davis, MB BS, PhD, FRACP, FAChPM, Medical Oncologist, Austin Health, Heidelberg, VIC; Associate Member and Head of Uro-oncology Laboratory, Ludwig Institute for Cancer Research, Austin Hospital, Heidelberg, VIC.
    Ms Lesley Dawson, MSc (Clin Pharm), BSc (Pharm), Clinical Educator & Specialist, Pharmacist Cancer Services, Mater Health Services, South Brisbane, QLD.
    Dr Richard W Eek, MBChB, MMed, FCP FRACP, Medical Oncologist, Border Medical Oncology, Wodonga, VIC; Murray Valley Private Hospital, Wodonga, VIC; Wangaratta Oncology Clinic, Wangaratta, VIC; Albury Base Hospital, NSW.
    Professor Andrew Grigg, MB BS, FRACP, FRCPA, MD, Director of Clinical Haematology, Department of Haemtaology, Austin Hospital, Heidelberg, VIC.
    Dr Ian Haines, MB BS, FRACP, FAChPM, Medical Oncologist, Cabrini and Alfred Hospitals, Melbourne, VIC; Adjunct Senior Lecturer, Department of Medicine, Monash University, Melbourne, VIC.
    Mr Allan M Hayward, RN, BN, GradDipN(Onc), GradCertNSc(Apher), Clinical Operations Manager, Royal Adelaide Hospital Cancer Centre, SA Pathology, Adelaide, SA.
    Ms Aisling Kelly, BSc (Hons), Pharmacist, Cancer Institute NSW, Alexandria, NSW.
    Mrs Suzanne W Kirsa, BPharm, Grad Dip Hosp Pharm, FSHP, Director of Pharmacy, Peter MacCallum Cancer Centre, East Melbourne, VIC.
    Associate Professor Bogda Koczwara, BM BS, FRACP, MBioethics, Head, Department of Medical Oncology and Director, Cancer Services, Southern Adelaide Health Service, SA; President Elect, Clinical Oncology Society of Australia.
    Mr Senthil Lingaratnam, BPharm, MPH, Clinical and Research Pharmacist, Peter MacCallum Cancer Centre, East Melbourne, VIC.
    Dr Linda Mileshkin, MB BS, MD, FRACP, MBioeth (Mon), Medical Oncologist, Peter MacCallum Cancer Centre, East Melbourne, VIC; Senior Fellow, The University of Melbourne, Parkville, VIC.
    Dr Orla Morrissey, MB, BCh, FRACP, Grad Dip (Clin Epi), PHD, Infectious Diseases Physician, Infectious Diseases Unit and Department of Haematology, The Alfred Hospital, Melbourne, VIC; Adjunct Senior Lecturer, Departments of Medicine and Haematology, Monash University, Melbourne, VIC.
    Ms Shay Morrissey, BAppSc (Nursing), GradCert (Oncology/Intensive Care), Nurse Unit Manager, Specialist Clinics, Peter MacCallum Cancer Centre, East Melbourne, VIC.
    Ms Annabel P McNally, B Pharm, MPS, Director of Pharmacy/Oncology Pharmacist, Pharmacist, Central Gippsland Health Service, Sale, VIC.
    Adjunct Clinical Associate Professor Mary O'Reilly, MB BS, MPH, FRACP, Head of Unit, Infectious Diseases and Infection Control, Eastern Health, Melbourne, VIC; Eastern Health Clinical School, Monash University, VIC; Infectious Diseases Physician, Cabrini Medical Centre, Malvern, VIC.
    Professor Miles Prince, MB BS (Hons), MD, MRACMA, FRACP, FRCPA, Head, Haematology Unit, Peter MacCallum Cancer Centre, East Melbourne, VIC; Director of the Blood and Marrow Transplant Service and the Edith Margaret Collie Centre for Blood Cell Therapies, East Melbourne, VIC.
    Dr William Renwick, MB BS, FRACP, FRCPA, Haematologist, Western Health and Royal Melbourne Hospital, Melbourne, VIC.
    Dr David S Ritchie, MB ChB, PhD, FRACP, FRCPA, Haematologist, Division of Haematology and Medical Oncology, East Melbourne, VIC; Haematologist, Clinical Haematology and Medical Oncology, Royal Melbourne Hospital, Parkville, VIC.
    Professor John F Seymour, MB BS, PhD, FRACP, Head, Haematology Department and Chair Haematology Clinical Service, Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC.
    Mr Jim Siderov, BPharm, MClinPharm, BCOP, Senior Pharmacist, Cancer Services, Austin Health, Melbourne, VIC.
    Associate Professor Monica A Slavin, MB BS, FRACP, MD, Head, Infectious Diseases, Peter MacCallum Cancer Centre, East Melbourne, VIC; Infectious Diseases Physician, Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville, VIC.
    Dr Brian Stein, MB BS, FRACP, Medical oncologist, Adelaide Cancer Centre and University of Adelaide, Adelaide, SA.
    Professor Jeff Szer, BMed Sc, MB BS, FRACP, Director, Department of Clinical Haematology and Bone Marrow Transplant Service, The Royal Melbourne Hospital, Parkville, VIC.
    Dr Constantine Tam, Haematology, MBBS, MD, FRACP, FRCPA, Consultant Haematologist, St Vincent's Hospital, Melbourne, VIC; Honorary Senior Fellow, University of Melbourne, VIC.
    Dr Anne Taylor, MB BS, FRACP, FAChPM, Medical Oncologist, Royal Adelaide Hospital, Adelaide, SA.
    Dr Karin A Thursky, BSc, MB BS, FRACP, MD, Infectious Diseases Physician, Peter MacCallum Cancer Centre and St Vincent's Hospital, Melbourne, VIC.
    Dr Craig Underhill, MB BS, FRACP, Medical Oncologist, Director of Cancer Services Hume Regional Cancer Centre, NSW; Director of Area Cancer Services, Greater Southern Area Health Service (Border Network), NSW; Conjoint Senior Lecturer, University of NSW, NSW.
    Dr Andrew Wei, MB BS, FRACP, FRCPA, PhD, Haematologist, Department of Clinical Haematology, Alfred Hospital, Prahran, VIC.
    Dr Leon J Worth, MB BS, FRACP, Grad Dip Epi, Infectious Diseases Physician, Peter MacCallum Cancer Centre, East Melbourne, VIC.

Karin A. Thursky, Department of Infectious Diseases, Peter MacCallum Cancer Centre Victorian Infectious Diseases service, Royal Melbourne Hospital St Vincent's Hospital, Melbourne, Victoria 3002, Australia. Email: Karin.Thursky@petermac.org

Abstract

The current consensus guidelines were developed to standardize the clinical approach to the management of neutropenic fever in adult cancer patients throughout Australian treating centres. The three areas of clinical practice covered by the guidelines, the process for developing consensus opinion, and the system used to grade the evidence and relative strength of recommendations are described. The health economics implications of establishing clinical guidance are also discussed.

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