Empirie Antibacterial Therapy in Granulocytopenia Induced by Cancer Chemotherapy
Authors: R H Rubin
Journal: Annals of Internal Medicine (1988)

Editorials1 January 1988Empirie Antibacterial Therapy in Granulocytopenia Induced by Cancer ChemotherapyROBERT H. RUBIN, M.D.ROBERT H. RUBIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-108-1-134 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFor the past two decades the empiric initiation of broad-spectrum antimicrobial therapy at the first sign of possible infection (unexplained fever, rigors, tachypnea, or acidosis) has been the cornerstone of managing infections in patients with cancer and chemotherapy-induced granulocytopenia. Such an approach produces a clinical response in approximately 75% of patients, whether or not infection is documented microbiologically (infection is documented in approximately 20% of febrile episodes). Early therapy before tissue infection enters the bloodstream, is believed to result in less morbidity and mortality than if therapy is delayed until blood culture results turn positive or focal findings appear (1-3)....References1. YOUNG L. Management of infections in leukemia and lymphoma. In: RUBIN RH, YOUNG LS, eds. Clinical Approach to Infection in the Compromised Host. 2nd ed. New York: Plenum Press; 1988:467-501. Google Scholar2. WADESCHIMPFFNEWMANFORTNERSTANDIFORDWIERNIK JSKCHP. Piperacillin or ticarcillin plus amikacin. A double-blind prospective comparison of empiric antibiotic therapy in febrile granulocytopenic cancer patients. Am J Med. 1981;71:983-90. CrossrefMedlineGoogle Scholar3. PIZZOHATHORNHIEMENZ PJJ. A randomized trial comparing ceftazadime alone with combination therapy in cancer patients with fever and neutropenia. N Engl J Med. 1986;315:552-8. CrossrefMedlineGoogle Scholar4. RUBINHATHORNMARSHALL MJD. Gram-positive infections and the use of vancomycin in 350 episodes of fever and neutropenia. Ann Intern Med. 1988;108:30-5. LinkGoogle Scholar5. LOWDERLAZARUSHERZIG JHR. Bacteremias and fungemias in oncologic patients with central venous catheters: changing spectrum of infection. Arch Intern Med. 1982;142:1456-9. CrossrefMedlineGoogle Scholar6. WADESCHIMPFFNEWMANWIERNIK JSKP. Staphylococcus epidermidis: an increasing cause of infection in patients with granulocytopenia. Ann Intern Med. 1982;97:503-8. LinkGoogle Scholar7. YOUNGMEYERSMOODYSCHIMPFF VWMS. The emergence of coryneform bacteria as a course of nosocomial infection in compromised hosts. Am J Med. 1981;70:646-50. CrossrefMedlineGoogle Scholar8. PIZZO P. Diagnosis and management of infectious disease problems in the child with malignant disease. In: RUBIN RH, YOUNG LS, eds. Clinical Approach to Infection in the Compromised Host. 2nd ed. New York: Plenum Press; 1988:439-66. Google Scholar9. KARPDICKANGELOPULOS JJC. Empiric use of vancomycin during prolonged treatment-induced granulocytopenia: a randomized, double-blind, placebo-controlled clinical trial in patients with acute leukemia. Am J Med. 1986;81:237-42. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital Harvard Medical School Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCarbenicillin, Carindacillin, Carfecillin and TicarcillinClinical Characteristics and Therapeutic Outcome of Patients with Febrile Neutropenia who Present in Shock: Need for Better StrategiesImipenem - Cilastatin versus Sulbactam - Cefoperazone plus Amikacin in the Initial Treatment of Febrile Neutropenic Cancer PatientsA randomized comparison of fluconazole with amphotericin B as empiric anti-fungal agents in cancer patients with prolonged fever and neutropeniaFeasibility of outpatient management of fever in cancer patients with low-risk neutropenia: Results of a prospective randomized trialOnce daily antibiotic regimen in paediatric oncology.Piperacillin/tazobactam/amikacin versus piperacillin/amikacin/teicoplanin in the empirical treatment of neutropenic patientsRandomised comparison of oral ofloxacin alone with combination of parenteral antibiotics in neutropenic febrile patientsNon-nephrotoxic empiric antimicrobial therapy in febrile neutropenic cancer patients9 Infections in the compromised childChemotherapy-induced neutropenia and fever in patients receiving cisplatin-based chemotherapy for ovarian malignancyTeicoplanin in the treatment of Gram-positive bacteraemia in neutropenic patientsMulticenter, randomized trial of ciprofloxacin plus azlocillin versus ceftrazidime plus amikacin for empiric treatment of febrile neutropenic patientsA RANDOMISED TRIAL OF EMPIRICAL ANTIBIOTIC THERAPY IN FEBRILE NEUTROPENIC PATIENTS WITH HEMATOLOGICAL DISORDERS: CEFTAZIDIME VERSUS AZLOCILLIN PLUS AMIKACINRandomized prospective study comparing vancomycin with teicoplanin in the treatment of infections associated with Hickman catheters 1 January 1988Volume 108, Issue 1Page: 134-136KeywordsAntibacterial therapyBacteremiaBloodCancer chemotherapyClinical microbiologyFeversHyperthermiaMorbidityMortalityTachypnea Issue Published: 1 January 1988 PDF downloadLoading ...