Overview of Empiric Antibiotic Therapy for the Febrile Neutropenic Patient

摘要: The febrile neutropenic patient with cancer requires the prompt administration of empirically chosen antibiotic therapy. For many years choice has usually been an aminoglycoside plus either a cephalosporin or antipseudomonal penicillin; exact combination was dependent on local patterns infection and especially microbial resistance. In absence resistance problems, one normally would choose least expensive and, probably, penicillin. A new approach to be considered is use single agents very broad spectra such as ceftazidime imipenem. However, fraught danger--that leaving resistant pathogen "uncovered" eliminating possible benefits synergistic activity against bacteremia due gram-negative organisms in profoundly patient. Combinations two beta-lactam have advantage not being nephro- ototoxic, although few combinations antagonism demonstrated. final regimens that include aztreonam, ceftazidime, imipenem, which little no suppressive effect stool anaerobes. Presumably, these colonization will preserved opportunities for secondary organism reduced.