Antimicrobial prophylaxis in febrile neutropenia

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Minoru Yoshida, Ryuzo Ohno

Abstract

Antibiotics generally considered for antibacterial prophylaxis for immunosuppressed patients are trimethoprim-sulfamethoxazole and the quinolones. Trimethoprim-sulfamethoxazole can significantly reduce infections and is highly effective in preventing pneumonia due to Pneumocystis carinii. However, it can cause sulfonamide-related reactions, myelosuppression, oral candidiasis, and development of bacterial resistance, and it lacks activity against Pseudomonas aeruginosa. Quinolones can reduce the occurrence of fever and infections in patients with neutropenia but do not provide adequate coverage against gram-positive bacteria, and inappropriate use can induce resistance among gram-negative organisms. Routine antibacterial prophylaxis is not recommended for patients likely to develop neutropenia. Antifungal prophylaxis is appropriate in settings in which fungal infections are frequent. Fluconazole is recommended for patients who are to undergo hematopoietic stem cell transplantation; it can be considered for elderly patients with acute leukemia who are to receive intensive chemotherapy. Itraconazole can also be used. Prophylaxis with antiviral agents is generally not indicated; however, it should be given to hematopoietic stem cel...Continue Reading

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Citations

Jul 14, 2004·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Juan J Picazo
Aug 3, 2010·International Journal of Antimicrobial Agents·Toshikazu YamazakiMikio Arisawa
Apr 18, 2006·Seminars in Hematology·Joel Gingerich, Eric J Bow
Oct 7, 2014·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Sol Cortés de MiguelInmaculada Vallejo-Rodríguez
Jun 6, 2019·Revista da Associação Médica Brasileira·Camila Ribeiro de Arruda MonteiroAuro Del Giglio
Jul 1, 2011·The Korean Journal of Internal Medicine·Dong-Gun LeeJung-Hyun Choi
Jun 7, 2017·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Shun-Ichi KimuraUNKNOWN Japan Adult Leukemia Study Group (JALSG)

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