Clinical Microbiology and Antimicrobial Chemotherapy. 2003; 5(1):47-73
Febrile neutropenia is becoming significant problem in Russian medical institutions. Changes in spectrum of causative pathogens, increase of the number of neutropenic patients and emergence of antimicrobial resistance – all the above factors require not only special attention of clinicians but also to the development of adequate practice guidelines. In our opinion at the moment the most valid guidelines for the therapy in febrile neutropenia is the recent guidelines of the Infectious Diseases Society of America (IDSA), so, in present article we try to adopt the above guidelines for the Russia. This article presents approach to the diagnostics and the risk stratification in patients with neutropenia. Empiric choice of antimicrobials is also considered. Antibacterial therapy of febrile neutropenia is described in detail. Practice guidelines for efficacy evaluation of treatment, its modifications and duration are given. Use of antiviral agents, colony-stimulating factors and granulocyte transfusion are considered. Antibiotic and antifungal prophylaxis for neutropenic patients is presented as well.