title: Bacterial lung sepsis in patients with febrile neutropenia.
abstract: OBJECTIVE
  This review provides an update on microbiological and therapeutic data in febrile neutropenic patients in general and those with bacterial lung sepsis in particular. Although the Infectious Diseases Society of America updated its guidelines on febrile neutropenia in 2010, changing epidemiological factors and the spread of new drug resistance constitutes challenges for initial treatment of this condition.
  
  
  RESULTS
  Lung sepsis stands out because of the frequent absence of microbiological identification. We review the use of newly available, novel, broad-spectrum antibiotics (linezolid, tigecycline, daptomycin, etc.) in this indication.
  
  
  CONCLUSIONS
  Although the incidence of Gram-negative infections in neutropenic fever is leveling off, there is a worrying increase in resistance. New drugs are available but not well studied in febrile neutropenia; daptomycin and tigecycline should not be used in suspected lung sepsis in these patients. New diagnostic tools (such as the procalcitonin assay and the LightCycler SeptiFast assay, Roche Molecular Systems) appear to be unhelpful in febrile neutropenia, although more data on fungal sepsis are required. There are no specific features of the treatment of pneumonia or septic shock in neutropenic fever, but both conditions increase the mortality rate.
authors.affiliation: Department of Infectious Diseases, Amiens University Medical Center, Amiens, France. lanoix.jean-philippe@chu-amiens.fr
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lanoix
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Schmit
authors.forename: Youcef
authors.initials: Y
authors.lastname: Douadi
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy / Q000209:etiology*; D005334:Fever / Q000209:etiology; D006801:Humans; D009369:Neoplasms / Q000150:complications; D009503:Neutropenia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011014:Pneumonia / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D012772:Shock, Septic / Q000188:drug therapy / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents