[Antibiotic therapy in leukopenia]

Praxis (Bern 1994). 1998 Sep 2;87(36):1120-5.
[Article in German]

Abstract

Intensified chemotherapy-induced long-term neutropenia is the main cause for morbidity and mortality of patients with hematologic malignancies. The successful management of neutropenia is based on hygienic procedures antimicrobial prophylaxis and therapy, and diagnostics. Until today, Co-Trimoxazole or fluoroquinolenes and oral amphotericine B are the prophylactic standard. The initial therapy of febrile neutropenia has to be started empirically before identification of causative pathogens or infectious foci. The febrile episodes should be treated with broad spectrum antibiotics (combinations or monotherapy) due to the spectrum of microorganisms or resistance situation at hospital. In case of non-response after 3-4 days the initial therapy should be modified, in addition to further antibacterial therapy the start with an antifungal drug has to be recommended. In patients with pulmonary infiltrates the early treatment with amphotericine B has been shown to be more advantageous than delayed antifungal therapy. Furthermore, the antibiotic therapy is based on proven microorganisms, susceptibility testing and infectious foci. The value of interventional treatment with G-CSF or GM-CSF is controversely discussed. An uncompromising handling of febrile neutropenia is necessary to reduce the mortality due to infections in patients with hematologic malignancies.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Bacterial Infections / drug therapy*
  • Hematologic Neoplasms / drug therapy*
  • Humans
  • Microbial Sensitivity Tests
  • Neutropenia / chemically induced
  • Neutropenia / drug therapy*
  • Opportunistic Infections / drug therapy*
  • Risk Factors

Substances

  • Anti-Bacterial Agents
  • Antineoplastic Agents