Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 Update by the Infectious Diseases Society of America Journal Article
| Authors: | Freifeld, A. G.; Bow, E. J.; Sepkowitz, K. A.; Boeckh, M. J.; Ito, J. I.; Mullen, C. A.; Raad, I. I.; Rolston, K. V.; Young, J. A. H.; Wingard, J. R. |
| Article Title: | Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 Update by the Infectious Diseases Society of America |
| Abstract: | This document updates and expands the initial Infectious Diseases Society of America (IDSA) Fever and Neutropenia Guideline that was published in 1997 and first updated in 2002. It is intended as a guide for the use of antimicrobial agents in managing patients with cancer who experience chemotherapy-induced fever and neutropenia. Recent advances in antimicrobial drug development and technology, clinical trial results, and extensive clinical experience have informed the approaches and recommendations herein. Because the previous iteration of this guideline in 2002, we have a developed a clearer definition of which populations of patients with cancer may benefit most from antibiotic, antifungal, and antiviral prophylaxis. Furthermore, categorizing neutropenic patients as being at high risk or low risk for infection according to presenting signs and symptoms, underlying cancer, type of therapy, and medical comorbidities has become essential to the treatment algorithm. Risk stratification is a recommended starting point for managing patients with fever and neutropenia. In addition, earlier detection of invasive fungal infections has led to debate regarding optimal use of empirical or preemptive antifungal therapy, although algorithms are still evolving. What has not changed is the indication for immediate empirical antibiotic therapy. It remains true that all patients who present with fever and neutropenia should be treated swiftly and broadly with antibiotics to treat both gram-positive and gram-negative pathogens. Finally, we note that all Panel members are from institutions in the United States or Canada; thus, these guidelines were developed in the context of North American practices. Some recommendations may not be as applicable outside of North America, in areas where differences in available antibiotics, in the predominant pathogens, and/or in health care-associated economic conditions exist. Regardless of venue, clinical vigilance and immediate treatment are the universal keys to managing neutropenic patients with fever and/or infection. © The Author 2011. |
| Keywords: | cancer chemotherapy; leukemia; antibiotic agent; neutropenia; review; antineoplastic agents; united states; antineoplastic agent; neoplasm; neoplasms; c reactive protein; unindexed drug; infection; neutrophil count; interleukin 8; evidence based practice; aciclovir; antifungal agent; creatinine; creatinine blood level; herpes simplex; influenza vaccination; practice guideline; urea nitrogen blood level; risk factor; high risk patient; risk assessment; abdominal pain; alanine aminotransferase blood level; aspartate aminotransferase blood level; coughing; fever; pneumonia; bilirubin; hypotension; antiinfective agent; acute leukemia; myelodysplastic syndrome; laboratory test; escherichia coli; ciprofloxacin; herpes virus; interleukin 6; thrombocyte count; allogeneic hematopoietic stem cell transplantation; thorax radiography; physical examination; blood cell count; leukocyte count; aminotransferase; staphylococcus aureus; infection prevention; methicillin resistant staphylococcus aureus; vancomycin resistant enterococcus; vancomycin; levofloxacin; quinoline derived antiinfective agent; influenza; streptococcus pneumoniae; antibiotic prophylaxis; canada; herpes simplex virus; caspofungin; fluconazole; candidiasis; mycosis; posaconazole; voriconazole; aspergillosis; micafungin; sialidase inhibitor; parainfluenza virus infection; respiratory syncytial pneumovirus; itraconazole; piperacillin plus tazobactam; methicillin resistant staphylococcus aureus infection; adenovirus; myeloid leukemia; pseudomonas aeruginosa; communicable diseases; aminoglycoside; cefepime; blood culture; anti-infective agents; fever of unknown origin; klebsiella; stenotrophomonas maltophilia; amoxicillin plus clavulanic acid; carbapenem; cilastatin plus imipenem; meropenem; common cold; klebsiella pneumoniae; acinetobacter; citrobacter; coagulase negative staphylococcus; enterobacter; streptococcus pyogenes |
| Journal Title: | Clinical Infectious Diseases |
| Volume: | 52 |
| ISSN: | 1058-4838 |
| Publisher: | Oxford University Press |
| Date Published: | 2011-01-01 |
| Start Page: | e56 |
| End Page: | e93 |
| Language: | English |
| DOI: | 10.1093/cid/cir073 |
| PUBMED: | 21258094 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 23 June 2011" - "CODEN: CIDIE" - "Source: Scopus" |
