Prevention of febrile leucopenia after chemotherapy in high-risk breast cancer patients: no significant difference between granulocyte-colony stimulating growth factor or ciprofloxacin plus amphotericin B

This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. There was no significant difference in the incidence of hospitalisation due to febrile leucopenia (FL) in the two groups. However, in the group receiving ciprofloxacin and amphotericin B (CAB), a larger number of patients appear to have been at risk of developing fever with a significantly higher incidence of grade IV leucopenia. The authors concluded that prophylactic CAB might be considered a reasonable alternative to recombinant human granulocyte-colony stimulating growth factor (rhG-CSF) in patients at high risk of FL. The economic aspect adds to the attraction of this alternative. The study also indicated that prophylactic CAB has similar efficacy to rhG-CSF in this setting and was more cost-effective.