An overview of the management of infection and febrile neutropenia in patients with cancer.
Infections remain a frequent complication in the care of patients with cancer, especially in those patients who sustain neutropenia during their disease course. Risk factors for infection in these patients include not only therapy-related myelosuppression, but also immune defects inherent to the underlying disease process. The bacterial spectrum of infection in these patients has changed over the decades, with infections caused by Gram-positive organisms now being more common than those infections because of Gramnegative isolates. Candida and Aspergillus species remain the most common causes of fungal infections. The approach to the antimicrobial management of these patients has been aided by the development of guidelines for care by the Infectious Disease Society of America (IDSA). The advent of new antimicrobial agents, especially antifungals, has impacted the care of these patients. In this article, the risk factors for infection, spectrum of infection, and approaches to antimicrobial management will be reviewed.
Morrison
Vicki A
VA
Sections of Hematology/Oncology and Infectious Disease, University of Minnesota, Veterans Affairs Medical Center, Minneapolis.