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Therapy of Febrile Neutropenia: An Algorithm for Current Clinical Attitudes Taking into Account Cost Benefit

  • Jean Klastersky
Conference paper

Abstract

The treatment of febrile neutropenia has changed over the past 20 years and still is in a constant phase of reevaluation in relationship to modifications of the nature of the offending pathogens, availability of new drugs for treatment of infections and changes in the type of patients who become neutropenic as a consequence of cytostatic therapy (1).

Keywords

Clin Oncol Febrile Neutropenia Empiric Therapy Neutropenic Fever Febrile Neutropenic Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Bodey GP. The treatment of febrile neutropenia from the dark ages to the present. Support Care Cancer 1997, 5:351–357.PubMedCrossRefGoogle Scholar
  2. 2.
    EORTC International Antimicrobial Therapy Cooperative Group. Ceftazidime combined with a short or long course of amikacin for empirical therapy of gram-negative bacteremia in cancer patients with granulocytopenia. N Eng J Med 1987, 317:1692–1698.CrossRefGoogle Scholar
  3. 3.
    EORTC International Antimicrobial Therapy Cooperative Group. Monotherapy with meropenem versus combination therapy with ceftazidime plus amikacin as empiric therapy for fever h granulocytopenic patients with cancer. Antimicrob Agents Chemother 1995, 40:1108–1115.Google Scholar
  4. 4.
    Freifeld AG, Walsh T, Marshall D et al. Monotherapy for fever and neutropenia in cancer patients:a randomized comparison of ceftazidime versus imipenem. J Clin Oncol 1995, 13:165–176.PubMedGoogle Scholar
  5. 5.
    Elting LS, Rubenstein EB, Rolston KVI et al. Outcomes of bacteremia in patients with cancer and neutropenia:observations from two decades of epidemiological clinical trials. Clin Infect Dis 1997, 25:247–59.PubMedCrossRefGoogle Scholar
  6. 6.
    Europen Organization for Research and Treatment of Cancer (EORTC) International Antimicrobial Therapy Cooperative Group and the National Cancer Institute of Canada — Clinical Trials Groups. Vancomycin added to empirical combination antibiotic therapy for fever h granulocytopenic cancer patients. J Infect Dis 1991, 163:951–958.CrossRefGoogle Scholar
  7. 7.
    Rubin M, Hathorn JW, Marshall D et al. Gram-positive infections and the use of vancomycin h 550 episodes of fever and neutropenia. Ann Intern Med 1988, 108:30–35.PubMedGoogle Scholar
  8. 8.
    Talcott JA, Siegel RD, Finberg R et al. Risk assessment in cancer patients with fever and neutropenia:a prospective, two-center validation of a prediction rule. J Clin Oncol 1992, 10:316–322.PubMedGoogle Scholar
  9. 9.
    The International Antimicrobial Therapy Cooperative Group of the European Organization for Research and Treatment of Cancer. Efficacy and toxicity of single daily doses of amikacin and ceftriaxone versus multiple daily doses of amikacin and ceftazidime for infection in patients with cancer and granulocytopenia. Ann Intern Med 1993, 119:584–593.Google Scholar
  10. 10.
    Sundararajan V, Rubenstein EB, Rolston KVI et al. Controversies in new antibiotic therapy for ambulatory patients. Support Care Cancer 1997, 5:358–364.PubMedCrossRefGoogle Scholar
  11. 11.
    Hartmann LC, Tschetter LK, Habermann TM et al. Granulocyte colony stimulating factor in severe chemotherapy induced afebrile neutropenia. New Engl J Med 1997, 336:1776–80.PubMedCrossRefGoogle Scholar
  12. 12.
    Messori A, Trippoli S, Tendi E. G-CSF for the prophylaxis of neutropenic fever in patients with small cell lung cancer receiving myelosuppressive antineoplastic chemotherapy:meta-analysis and pharmacoeconomic evaluation. J Clin Pharmacy & Ther 1996, 21:57–63.CrossRefGoogle Scholar
  13. 13.
    Geissler K, Koller E, Hubmann E et al. Granulocyte colony-stimulating factor as an adjunct to induction chemotherapy for adult acute lymphoblastic leukemia:a randomized phase III study. Blood 1997, 90:590–596.PubMedGoogle Scholar
  14. 14.
    Mitchell PLR, Morland B Stevens MCG et al. Granulocyte colony-stimulating factor h established febrile neutropenia:a randomized study of pediatric patients. J Clin Oncol 1997, 15:1163–1170.PubMedGoogle Scholar
  15. 15.
    Maher DW, Lieschke GJ, Green M et al. Filgrastim in patients with chemotherapy-induced febrile neutropenia. Ann Intern Med 1994, 121:492–501.PubMedGoogle Scholar
  16. 16.
    Vellenga E, Uyl-de Groot CA, de Wit R et al. Randomized placebo-controlled trial of granulocyte-macrophage colony-stimulating factor in patients with chemotherapy-related febrile neutropenia. J Clin Oncol 1996, 14:619–627.PubMedGoogle Scholar
  17. 17.
    Anaissie EJ, Vartivarian S, Bodey GP et al. Randomized comparison between antibiotics alone and antibiotics plus granulocyte-macrophage colony-stimulating factor (Escherichia coli-delivered) in cancer patients with fever and neutropenia. Am J Med 1995, 100:17–23.CrossRefGoogle Scholar
  18. 18.
    Schimpff SC. Growth factors and empiric therapy with antibiotics:should they be used concurrently ? Ann Intern Med 1994, 121:538–540.PubMedGoogle Scholar
  19. 19.
    Cruciarli M, Rampazzo R, Malena M et al. Prophylaxis with fluoroquinolones for bacterial infections in neutropenic patients:a meta-analysis. Clin Infect Dis 1996, 23:795–805.CrossRefGoogle Scholar
  20. 20.
    Blay JY, Chauvin F, Le Cesne A et al. Early lymphopenia after cytotoxic chemotherapy as a risk factor for febrile neutropenia. J Clin Oncol 1996, 14:636–643.PubMedGoogle Scholar
  21. 21.
    Rossi C, Klastersky J. Initial empirical antibiotic therapy for neutropenic fever: analysis of the causes of death. Support Care Cancer 1996, 4:207–212.PubMedCrossRefGoogle Scholar
  22. 22.
    Klastersky J. Treatment of neutropenic infection:trends towards monotherapy ? Support Care Cancer 1997, 5:365–370.PubMedCrossRefGoogle Scholar
  23. 23.
    Murphy M, Brown AE, Sepkowitz KA et al. Fluoroquinolone prophylaxis for the prevention of bacterial infections in patients with cancer — is it justified ? Clin Infect Dis 1997, 25:346–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1998

Authors and Affiliations

  • Jean Klastersky
    • 1
  1. 1.Service de Médecine et Laboratoire de Recherche et d’Investigation Cliniques H.J. Tagnon, Institut Jules BordetCentre des Tumeurs de l’Université Libre de BruxellesBruxellesBelgique

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