radiography. Oral ciprofloxacin and levofloxacin were used as antibacterial agents in 11 and 3 sites, respectively. When the HSCT group was considered, it was found that antimicrobial prophylaxis was done in 30 sites (90.9%). Antibacterial agents were prescribed in 28 sites (84.8%). Oral ciprofloxacin was used as the antibacterial agent in 20 of the sites (60.6%), whereas oral levofloxacin was used in 5 of the sites (15.2%). In addition, roxithromycin or a combi- nation of either ciprofloxacin plus metronidazole or vanco- mycin plus colimycin (colistimethate sodium) was used oral- ly in 1 site each. Antifungal prophylaxis was done in 30 sites (90.9%), with oral fluconazole or itraconazole being admin- istered in 25 of 28 sites that responded to the question, and amphotericin B deoxycholate or nystatin also being admin- istered in 3 sites (data were not mutually exclusive). Twen- ty-one sites (63.6%) used oral acyclovir for antiviral prophy- laxis, whereas intravenous (IV) acyclovir was used in 5 sites (15.2%), and ganciclovir was used in 2 sites. Co-trimoxa- zole was prescribed for pneumocystis prophylaxis in 29 sites (87.9%) and it was coupled with pentamidine inhalation in one site. Anti-tuberculous prophylaxis with isoniazid was done in 3 sites; however different doses were used among the sites (dose, 300-400 mg/day, or 10 mg/kg/day). Empirical therapy and modification of initial therapy The most commonly prescribed regimen for empirical antibiotic therapy of neutropenic fever was one cephalosporin (ceftazidime or cefepime) plus one aminoglycoside in 50.0% and 43.7% of the chemotherapy and HSCT group, respec- tively (Table 1). Overall, combination regimen using an aminoglycoside plus either cephalosporin, carbapenem or an antipseudomonal penicillin was used as empirical therapy in 71.9% and 65.6% of the chemotherapy and HSCT group, Regimen Combination therapy Monotherapy Both Chemotherapy group Cephalosporin+AG [cefepime/3rd cephalosporin/both] Piperacillin or Pip/Taz+AG Ceftazidime+levofloxacin Ceftazidime+AG+vancomycin Cephalosporin only [Cefepime/ceftazidime] Pip/Taz only Table 1. Empirical antimicrobial regimens in the treatment of neutropenic fever Total number of sites responded=32 Cefepime or ceftazidime or Pip/Taz±AG Cefepime or ceftazidime or Pip/Taz±AG HSCT, hematopoietic stem cell transplantation; AG, aminoglycoside; Pip/Taz, piperacillin/tazobactam. A Nationwide Survey for the Management of Neutropenic Fever in Korea 943 N (%) 5 (15.1) 20 (60.6) 4 (12.1) 2 (6.1) 1 (3.0) 1 (3.0) N (%) 21 (65.6) 14 (43.7) [3/11] 1 (3.1) 5 (15.6) 1 (3.1) 9 (28.1) 6 (18.7) [5/1] 1 (3.1) 1 (3.1) 1 (3.1) 2 (6.2) 2 (6.2) respectively. Additionally, carbapenem monotherapy was used as an initial empirical therapy in one site for the HSCT group. As for glycopeptides, vancomycin was used at 17 sites (51.5%), whereas teicoplanin was used at 10 sites (30.3%), and both were used at 6 sites (18.2%). A glycopeptide was routinely prescribed as part of an initial empirical therapy in only 2 out of 22 sites that responded to the question, which suggested that most sites do not feel that glycopeptide was a necessary part of the initial regimen. In 19 (86.4%) of the 22 sites that responded to the question, glycopeptide was started for selected patients based on the IDSA guideline. And 21 out of 32 sites (65.6%) that answered the question stated that they stopped glycopeptide when an absolute neu- trophil count (ANC) was recovered over 500 cells/μL and any sign of infection by gram positive organisms disappeared. Additionally, in 7 out of 32 sites (21.9%), glycopeptide was discontinued immediately when signs and symptoms of infec- tion induced by gram positive organisms disappeared regard- less of ANC. Table 2. Criteria for changing the initial empirical regimen Total number of sites that responded=33 Persistent fever for 2-3 days Persistent fever for 2-3 days or aggravated clinical symptom in 1-2 days Persistent fever for 3-4 days Persistent fever for 3-5 days or aggravated clinical symptom in 1-2 days Persistent fever for 3-7 days or aggravated clinical symptom in 1-2 days Second set fever or septic shock N (%) 23 (71.9) 16 (50.0) [4/11/1] 5 (15.6) 1 (3.1) 1 (3.1) 7 (21.9) 6 (18.7) [5/1] 1 (3.1) 2 (6.2) 2 (6.2) HSCT group Cephalosporin+AG [cefepime/3rd cephalosporin/both] Cefepime+carumonam Piperacillin or Pip/Taz+AG Ceftazidime+AG+vancomycin Cephalosporin only [Cefepime/ceftazidime] Pip/Taz only Carbapenem only Other