Please use this identifier to cite or link to this item:
|Title:||European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European Conference on Infections in Leukemia||Authors:||Averbuch, Diana
Livermore, David M.
Kern, Winfried V.
|Issue Date:||2013||Source:||HAEMATOLOGICA, 98 (12), p. 1826-1835||Abstract:||Owing to increasing resistance and the limited arsenal of new antibiotics, especially against Gram-negative pathogens, carefully designed antibiotic regimens are obligatory for febrile neutropenic patients, along with effective infection control. The Expert Group of the 4th European Conference on Infections in Leukemia has developed guidelines for initial empirical therapy in febrile neutropenic patients, based on: i) the local resistance epidemiology; and ii) the patient's risk factors for resistant bacteria and for a complicated clinical course. An 'escalation' approach, avoiding empirical carbapenems and combinations, should be employed in patients without particular risk factors. A 'deescalation' approach, with initial broad-spectrum antibiotics or combinations, should be used only in those patients with: i) known prior colonization or infection with resistant pathogens; or ii) complicated presentation; or iii) in centers where resistant pathogens are prevalent at the onset of febrile neutropenia. In the latter case, infection control and antibiotic stewardship also need urgent review. Modification of the initial regimen at 72-96 h should be based on the patient's clinical course and the microbiological results. Discontinuation of antibiotics after 72 h or later should be considered in neutropenic patients with fever of unknown origin who are hemodynamically stable since presentation and afebrile for at least 48 h, irrespective of neutrophil count and expected duration of neutropenia. This strategy aims to minimize the collateral damage associated with antibiotic overuse, and the further selection of resistance.||Notes:||Averbuch, D (reprint author), Hadassah Hebrew Univ, Med Ctr, Pediat Infect Dis Unit, Jerusalem, Israel. firstname.lastname@example.org||Document URI:||http://hdl.handle.net/1942/16150||ISSN:||0390-6078||e-ISSN:||****-****||DOI:||10.3324/haematol.2013.091025||ISI #:||000328545500010||Category:||A1||Type:||Journal Contribution||Validations:||ecoom 2015|
|Appears in Collections:||Research publications|
Show full item record
Files in This Item:
|averbuch 1.pdf||published version||651.81 kB||Adobe PDF||View/Open|
checked on Sep 3, 2020
WEB OF SCIENCETM
checked on May 21, 2022
checked on May 20, 2022
checked on May 20, 2022
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.