[Febrile neutropenia: empiric antibiotic therapy from 1975 to 1997].
Monotherapy with ceftazidime, cefepime, imipenem or meropenem for the empiric treatment of febrile neutropenia appears as effective as the combination therapy involving aminoglycosides. However, empiric therapy with a combination of a beta-lactam plus an aminoglycoside is a reasonable decision under circumstances where Gram negative sepsis is very likely. Monotherapy is usually associated with a modest rate of response in infections caused by Gram positive organisms. In about 30% of the patients, a glycopeptide will be added at some point, because the response to the initial therapy is not considered optimal.
Klastersky
J
J
Service de Médecine Interne, Institut Jules Bordet, Université Libre de Bruxelles.
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D000077723:Cefepime; D002442:Ceftazidime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005334:Fever / Q000188:drug therapy; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D000077731:Meropenem; D009503:Neutropenia / Q000188:drug therapy*; D018805:Sepsis / Q000188:drug therapy; D013845:Thienamycins / Q000627:therapeutic use
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D013845:Thienamycins; D015378:Imipenem; D000077723:Cefepime; D002442:Ceftazidime; D000077731:Meropenem