RT Journal Article
SR Electronic
T1 Febrile neutropenia. Etiology of infection, empirical treatment and prophylaxis
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 331
OP 336
VO 24
IS 4
A1 Eltahawy, Ahmed T.
YR 2003
UL http://smj.org.sa/content/24/4/331.abstract
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.