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Cited by 1,964Neutropenia and Cancer InfectionsAntifungal resistance and susceptibilityAntibiotic Use and Resistance

2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer

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Hughes, Walter T., Armstrong, Donald, Bodey, Gerald P., Bow, Eric J., Brown, Arthur E., Calandra, Thierry, Feld, Ronald, Pizzo, Philip A. +3 more·2002·Clinical Infectious Diseases
DOI 10.1086/339215
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Abstract

This article, prepared by the Infectious Diseases Society of America (IDSA) Fever and Neutropenia Guidelines Panel, updates guidelines established a decade ago by the Infectious Disease Society of America for the use of antimicrobial agents to treat neutropenic patients with unexplained fever [1]. DefinitionsFever is defined as a single oral temperature of у38.3ЊC (101ЊF) or a temperature of у38.0ЊC (100.4ЊF) for у1 h.Neutropenia is defined as a neutrophil count of !500 cells/mm 3 , or a count of !1000 cells/mm 3 with a predicted decrease to !500 cells/mm 3 . Initial EvaluationDetermine whether the patient is at low risk for complications; determine whether vancomycin therapy is needed. Initial Antibiotic TherapyOral route.For low-risk adults only; use ciprofloxacin plus amoxicillin-clavulanate. Monotherapy with vancomycin not indicated.

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  • The value of preemptive therapy has been best documented in the persistently neutropenic patient, and current guidelines suggest adding a broad spectrum antifungal agent in a neutropenic patient with persistent fever for 5 days despite broad spectrum antibiotics.

    “The value of preemptive therapy has been best documented in the persistently neutropenic patient, and current guidelines suggest adding a broad spectrum antifungal agent in a neutropenic patient with persistent fever for 5 days despite broad spectrum antibiotics.”

    From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [192]

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Research works printed but not linked: 17

  1. Dale DC, Guerry D 4th, Wewerka JR, Chusid MJ. Chronic neutro- penia. Medicine (Baltimore) 1979; 58:128-44.
  2. Rolston RVI, Balakrishnan M, Elting LS, et al. Is quantitative variation in cancer patients with bacteremic infections linked to severity of infection? [abstract 729]. In: Program and abstracts of the 40th In- terscience Conference for Antimicrobial Agents and Chemotherapy (Toronto). Washington, DC: American Society for Microbiology, 2000.
  3. Bodey GP, Fainstein V. Systemic candidiasis. In: Bodley GP, Fainstein V, eds. Candidiasis. New York: Raven Press, 1985:135-68.
  4. Pizzo PA, Ladisch S, Robichaud K. Treatment of gram-positive sep- ticemia in cancer patients. Cancer 1980; 45:206-7.
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  8. Malik IA, Abbas A, Karim M. Randomized comparison of oral of- loxacin alone with combination of parenteral antibiotics in neutro- penic febrile patients. Lancet 1992; 339(8801):1092-6.
  9. Biron P, Fuhrmann C, Cure H, et al. Cefepime versus imipenem- cilastatin as empirical monotherapy in 400 febrile patients with short duration neutropenia: CEMIC. J Antimicrob Chemother 1998; 42: 511-8.
  10. Raad II, Abi-Said D, Rolston KV, et al. How should imipenem-cilas- tatin be used in the treatment of fever and infection in neutropenic cancer patients? Cancer 1998; 82:2449-58.
  11. Oblon D, Ramphal R. A randomized trial of cefepime vs. ceftazidime as initial therapy for patients with prolonged fever and neutropenia after intensive chemotherapy [abstract]. In: Proceedings of the annual meeting of the American Association for Cancer 1993; 34:1362A.
  12. Owens RC, Owens CA, Holloway WJ. Reduction in vancomycin con- sumption in patients with fever and neutropenia [abstract 458]. Clin Infect Dis 2000; 31:291.
  13. Malik IA, Abbas Z, Karim M. Randomized comparison of oral of- loxacin alone with combination of parenteral antibiotics in neutro- penic febrile patients. Lancet 1992; 339:1092-6.
  14. Brown AE, Kiehn TE, Armstrong D. Bacterial resistance in the patient with neoplastic disease. Infect Dis Clin Pract 1995; 4:136-44.
  15. Rolston KVI, LeBlanc H, Ho DH. In vitro activity of gatifloxacin against gram-negative isolates from cancer patients [abstract 359]. In: Program and abstracts of the 39th Interscience Conference on An- timicrobial Agents and Chemotherapy (San Francisco). Washington, DC: American Society for Microbiology, 1999.
  16. Peacock JE, Wade JC, Lazarus HM, et al. Ciprofloxacin/piperacillin vs. tobramycin/piperacillin as empiric therapy for fever in neutropenic cancer patients, a randomized, double-blind trial [abstract 373]. In: Program and abstracts of the 37th Interscience Conference on An- timicrob Agents and Chemotherapy (Toronto). Washington, DC: American Society for Microbiology, 1997.
  17. Harvey WH, Harvey JH, Moskowitz MJ. Ciprofloxacin/vancomycin (C/V) as initial empiric therapy in febrile neutropenic leukemia/lym- phoma patients (pts) with indwelling venous access devices: prelim- inary results of an effective regimen with reduced hospital stay [ab- stract A1639]. In: Proceedings of the annual meeting of the American Society of Clinical Oncology, 1994. 13.

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Authors
Hughes, W. T., Armstrong, D., Bodey, G. P., Bow, E. J., Brown, A. E., Calandra, T., Feld, R., Pizzo, P. A., Rolston, K. V. I., Shenep, J. L., & Young, L. S.
Affiliations
  • St. Jude Children's Research Hospital (US)
  • Memorial Sloan Kettering Cancer Center (US)
  • The University of Texas MD Anderson Cancer Center (US)
  • University of Manitoba (CA)
  • Centre Hospitalier Universitaire Vaudois (CH)
  • Princess Margaret Cancer Centre (CA)
  • Harvard University (US)
  • Kuzell Institute for Arthritis, San Francisco, California
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2002-03-15
Volume
34
Issue
6
Pages
730-751
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/339215
OpenAlex
W2166858780
Cited by
1,964
References
181
Citations by year
2026: 7 · 2025: 20 · 2024: 13 · 2023: 14 · 2022: 23 · 2021: 19 · 2020: 28 · 2019: 34 · 2018: 33 · 2017: 36 · 2016: 56 · 2015: 56 · 2014: 74 · 2013: 74 · 2012: 93
FWCI
51.58
Type
journal article
Language
en
Open access
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • SERVAL (Université de Lausanne) (publishedVersion, other-oa)
  • reroDoc Digital Library (submittedVersion)
  • IRIS (submittedVersion)
Funders
Centre Hospitalier Universitaire Vaudois
Topics
  • Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
Keywords
febrile neutropenia, cancer patients, antimicrobial therapy, neutropenia, initial antibiotic therapy, ciprofloxacin, amoxicillin-clavulanic acid, vancomycin, low-risk patients, oral antibiotic therapy
MeSH terms
Anti-Infective Agents, Drug Therapy, Evaluation Studies as Topic, Fever, Humans, Neoplasms, Neutropenia

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