PT  - JOURNAL ARTICLE
AU  - Eltahawy, Ahmed T.
TI  - Febrile neutropenia. Etiology of infection, empirical treatment and prophylaxis
DP  - 2003 Apr 01
TA  - Saudi Medical Journal
PG  - 331--336
VI  - 24
IP  - 4
4099  - http://smj.org.sa/content/24/4/331.short
4100  - http://smj.org.sa/content/24/4/331.full
SO  - Saudi Med J2003 Apr 01; 24
AB  - Much has changed in the treatment of patients with fever and neutropenia, including the patterns of microbial flora and drug resistance, and the drugs used. Gram-positive organisms have overshadowed the gram-negative ones as causes of bacteremia. Changes in therapy may include antimicrobials directed against gram-positive bacteria, resistant gram-negative bacteria, or fungi. Due to the high risk for colonization by vancomycin resistant Enterococci, vancomycin use is restricted as first line empiric therapy unless the patient is at high-risk for serious gram-positive infection. Prophylactic antibiotic therapy may increase the selection of resistant strains and should be avoided. Therapy with colony stimulating factor is only considered for patients who remain severely neutropenic and have documented infections that do not respond to appropriate antibacterial therapy. Patients stratification for risk of infection-associated morbidity and mortality is essential to facilitate treatment decision.