The new research, published in a recent issue of The New England Journal of Medicine (Vol. 341, No. 5), suggests that if patients do not have other complications, such as low blood pressure, lung problems, or abdominal pain, giving oral antibiotics is just as safe. Patients with low risk of complications were examined in the studies. The studies excluded high-risk patients with other medical complications such as HIV infection or stem-cell transplantation and patients who were expected to have low white blood cell counts for longer than 10 days.

Giving oral antibiotics eliminates the need to give the patient antibiotics intravenously, thus allowing some patients the option of outpatient treatment because there is no need to give multiple daily infusions, said Winfried V. Kern, MD, lead author of one of the studies. Also, the cost of therapy is reduced, Dr. Kern said.

Data from one of the studies show oral antibiotics worked in 71 percent of 116 patients, compared with 67 percent of the 116 patients who were given intravenous antibiotics. The other study shows an 86 percent success rate for the 177 patients receiving oral antibiotics, compared with an 84 percent success rate among the 176 people treated intravenously.

Because radiation and chemotherapy often decrease the number of infection-fighting white blood cells in cancer patients, doctors give antibiotics at the first sign of a fever to keep infections away.  Treating patients with oral antibiotics rather than intravenous antibiotics is more convenient and less expensive because patients can be treated at home.

"Oral antibiotics are as safe as intravenous antibiotics if the patients for oral therapy are carefully selected," said Dr. Kern. If the patient is treated at home, however, careful rules for contacting the doctor in case of a problem need to be established, Dr. Kern said.

Patients should not be pressed into using oral antibiotics instead of intravenous treatment and should choose the oral therapy only after detailed discussion with their doctor if they feel prepared for it, Dr. Kern added.

LaMar McGinnis, MD, medical consultant for the American Cancer Society (ACS), believes the research is good news for patients and their families. "This is a quality of life issue for many since it is easier to take antibiotics by mouth than to be injected," he said.

Although some patients may feel they are being treated more vigorously if they are given antibiotics intravenously, Dr. McGinnis said they should feel confident about receiving oral antibiotics.

He cautions that there are some safety risks involved because patients are not monitored as closely at home as they are in a hospital, but adds there is a higher risk of infection in a hospital environment when compared to a home environment.