ACTA FAC. MED. NAISS. 2003; 20 (2): 101-108

Original article

THERAPY OF FEBRILE NEUTROPENIA IN PATIENTS WITH MALIGANCY

-single center expirience and recommendationes-

Goran Marjanović¹, Vesna Marjanović², Mladen Milenović¹, Lana Mačukanović-Golubović¹, Tomislav Vukićević¹

¹ Clinic of Hematology and Clinical Immunology ,Clinical Centre Nis

² Clinic of Child Surgery and Orthophedia, Clinical Centre Nis

Author’s address:

 26/7Sinđelicev trg, 18000 Nis

tel:  510160

e-mail: goranves@ EUnet.yu

Summary:

In the selection of the initial antibiotic regimen, one should consider the type, frequency of occurrence, and antibiotic susceptibility of bacterial isolates recovered from other patients at the same hospital. We emphasize that no specific scheme, no specific drug or combination of drugs, and no specific period of treatment can be unequivocally applied to all febrile neutropenic patients. The outpatient approach with oral antibiotics for low risk group of patients should be apllied whenever possible. Hospital tretment is mandatory for all accute leukemia patients with various initial empirical antibiotic therapy aproaches such as monotherapy, therapy consisting of 2 parenteral drugs with or without addition of vankomycine. Our expirience with accute leukemia patients favor the last combination.

In this study recommendations conserning antiviral prophilaxis, duration of antibiotic therapy as well as situations when changes of regimen are necessery in casess of prolonged neutropenia with complications were rewieved.

It is important to note that the guidelines are general and must be applied wisely with respect to variations in individual patients and types of infections, settings in which patients are being treated, antimicrobial susceptibility patterns, underlying causes of neutropenia, and expected time of recovery.

Key words: Febrile neutropenia, cancer, hematological malignacy, antibiotic therapy