Fever and Granulocytopenia: A Viewpoint from an Academic Setting
The optimal management of the febrile neutropenic patient continues to be controversial (Pizzo and Meyers 1989). There are numerous factors which must be taken into account when making recommendations for empiric therapy (Talcott et al. 1988; Pizzo et al. 1984). These factors include the age of the patient and the underlying diagnosis, the type of induction regimen used to treat the underlying disease, the presence of concomitant illnesses (i.e., renal/cardiac/hepatic), the expected duration of neutropenia, the nature and duration of prior infectious episodes, the clinical clues which exist to suggest a source for the neutropenic fever, and the expected organisms and their resistance patterns within that particular hospital. Clearly, if prospective clinical trials of antibiotic regimens are available, patients should be entered into such trials (Table 1).
KeywordsGentamicin Etoposide Doxycycline Ketoconazole Aminoglycoside
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