Fever and neutropenia clinical practice guidelines.
Significant progress has been made in managing fever and neutropenia in patients with cancer. Although initial empiric antimicrobial treatment remains the foundation of therapy for such patients, improved diagnostic modalities, models of risk assessment, and an understanding of the various clinical situations in which infections occur have required that treatment approaches and options evolve. The development of broad-spectrum antibiotics with decreased toxicity has improved patient outcomes. Nevertheless, the increasing prevalence of antibiotic-resistant pathogens has challenged the clinician to use antimicrobial therapy wisely. Infection control should not rely exclusively on antimicrobial prophylaxis but, rather, should continue to incorporate standard infection control measures and demand careful handwashing by all health care professionals who come into contact with immunocompromised patients. Invasive fungal pathogens have increased and remain a major concern. Diagnostic and therapeutic modalities for fungal infections remain limited, but careful clinical investigation of new approaches will be needed to define the proper use of these probably expensive new therapeutic additions.
Freifeld
Alison G
AG
Baden
Lindsey Robert
LR
Brown
Arthur E
AE
Elting
Linda S
LS
Gelfand
Michael
M
Greene
John N
JN
Ito
James I
JI
King
Earl
E
Marcucci
Guido
G
Montoya
Jose G
JG
Morris
Ashley
A
Noskin
Gary
G
Rolston
Ken
K
Schott
Anne F
AF
Segal
Brahm
B
D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods; D000935:Antifungal Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy; D005334:Fever / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D017408:Guidelines as Topic; D006801:Humans; D016867:Immunocompromised Host / Q000502:physiology; D017053:Infection Control / Q000379:methods; D008171:Lung Diseases / Q000209:etiology / Q000628:therapy; D009181:Mycoses / Q000150:complications / Q000188:drug therapy; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D009503:Neutropenia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents