Аннотация
Нейтропеническая лихорадка становится всё более актуальной проблемой стационаров лечебно-профилактических учреждений России. Меняющийся спектр возбудителей инфекций, рост их антибиотикорезистентности, увеличение числа пациентов, относящихся к контингенту с факторами риска развития нейтропенической лихорадки, требуют не только пристального внимания клиницистов к данной проблеме, но и разработки четких рекомендаций по ведению таких больных. В настоящее время наиболее полноценными рекомендациями по ведению пациентов с фебрильной нейтропенией, на наш взгляд, являются рекомендации Американского общества инфекционных болезней (IDSA). В связи с этим данная статья представляет собой попытку адаптировать указанные рекомендации к российским условиям. В статье рассмотрены вопросы диагностики и стратификации факторов риска у пациентов данной группы. Описан выбор препаратов для эмпирической и этиотропной терапии. Рассмотрены возможности антибиотикотерапии нейтропенической лихорадки. Приведены рекомендации по оценке эффективности терапии, методики ее модификации и определения продолжительности лечения. Даны рекомендации по применению противовирусных препаратов, колониестимулирующих факторов и трансфузий гранулоцитарной массы. Освещены вопросы антибиотикопрофилатики нейтропенической лихорадки.
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