title: Tackling antibiotic resistance in febrile neutropenia: current challenges with and recommendations for managing infections with resistant Gram-negative organisms.
abstract: Multidrug resistant (MDR) Gram-negative bacteria (GNB) have emerged as important pathogens and a serious challenge in the management of neutropenic patients worldwide. The great majority of infections are caused by the Enterobacteriaceae (especially Escherichia coli and Klebsiella spp.) and Pseudomonas aeruginosa, and less frequently Acinetobacter spp. and Stenotrophomonas maltophilia. A broader-spectrum empiric antibiotic regimen is usually recommended in patients with a history of prior bloodstream infection caused by a MDR GNB, in those colonized by a MDR GNB, and if MDR GNBs are frequently isolated in the initial blood cultures. In any situation, de-escalation to standard empiric regimen is advised if infection with MDR GNB is not documented.
authors.affiliation: a 1 University Hospital, Universidade Federal do Rio de Janeiro, Rua Rodolpho Paulo Rocco 255 - 21941-913 Rio de Janeiro, Brazil.
authors.forename: Simone A
authors.initials: SA
authors.lastname: Nouér
authors.forename: Marcio
authors.initials: M
authors.lastname: Nucci
authors.forename: Elias
authors.initials: E
authors.lastname: Anaissie
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D019468:Disease Management; D024881:Drug Resistance, Bacterial; D024901:Drug Resistance, Multiple, Bacterial; D064147:Febrile Neutropenia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006090:Gram-Negative Bacteria; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D006801:Humans; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic; epidemiology; febrile neutropenia; resistance; treatment