The Infectious Diseases Society of America 2002 Guidelines for the Use of Antimicrobial Agents in Patients with Cancer and Neutropenia: Salient Features and Comments

Rolston, Kenneth V. I.
July 2004
Clinical Infectious Diseases;7/15/2004 Supplement 1, Vol. 39, pS44
Academic Journal
Infection remains the most common complication of chemotherapy-induced neutropenia. Bacterial infections predominate initially. Invasive fungal infections occur in patients with prolonged neutropenia. Chensoprophylaxis is recommended only for patients at high risk. Initial empirical therapy is based on local epidemiology and drug-susceptibility patterns. Patients at low risk can be treated as outpatients. Other patients need hospital-based, parenteral therapy. Several options are available, including combination regimens or monotherapy. Initial antimicrobial coverage against Pseudomonas species is necessary. Subsequent management depends on the nature of the febrile episode. If defervescence occurs within 3-5 days and no pathogen has been identified, the initial regimen or a suitable oral regimen can be used to complete a 7- to 10-day course. If the etiology has been established, therapy can be adjusted for optimal coverage (activity against gram-negative organisms must be maintained), If fever persists for longer than 3-5 days, assessment for a fungal infection, a resistant organism, or a new infectious focus should be conducted and empirical antifungal therapy instituted.


Related Articles

  • Prophylaxis of Invasive Fungal Infections: A Review of the Use of Posaconazole. Collins, Curtis D.; Smith, Jeannina A.; Kaul, Daniel R. // Clinical Medicine: Therapeutics;2009, Issue 1, p1399 

    Invasive fungal infections (IFIs) cause significant morbidity, mortality, and increased cost of care in patients with hematological malignancies, prolonged (i.e. < 7-10 days) treatment induced neutropenia, and other disease states causing underlying immunosuppression. One strategy often used to...

  • Reduced susceptibility to ceftriaxone in Neisseria gonorrhoeae is spread internationally by genetically distinct gonococcal populations. Whiley, David M.; Goire, Namraj; Lambert, Stephen B.; Nissen, Michael D.; Sloots, Theo P.; Tapsall, John W. // Journal of Antimicrobial Chemotherapy (JAC);May2011, Vol. 66 Issue 5, p1186 

    The article provides further evidence of the international spread in Neisseria gonorrhoeae exhibiting reduced susceptibility to ceftriaxone and that gonococci strains are genotypically diverse. The study uses multilocus sequence typing (MLST) to further examine the genotypic diversity of 20...

  • Antibiotics, 1972. Plotkin, Stanley A. // Clinical Pediatrics;Dec1972, Vol. 11 Issue 12, p671 

    Discusses antibiotics and approaches to chemotherapy at the eleventh Interscience Conference on Antimicrobial Agents and Chemotherapy in Atlantic City, New Jersey. Efficacy of carbenicillin and gentamicin for oral antipseudomonous; Formulations of cephalosporins, cephapirin and cephanone that...

  • FLUOROQUINOLONES.  // Davis's Drug Guide for Nurses, 10th edition;2007, p530 

    This article presents a nursing guide to the anti-infective agent fluoroquinolones. Drug information provided includes pharmacokinetics, contraindications or precautions, adverse reactions or side effects, interactions, route or dosage, and availability. Popular brands are Cipro, Cipro XR and...

  • Neutropenia in patients receiving long-term cefepime therapy for osteomyelitis. Wong, Brian B.; Ko, Gerald J. // American Journal of Health-System Pharmacy;11/1/2003, Vol. 60 Issue 21, p2229 

    The frequency of neutropenia in patients receiving long-term cefepime therapy for osteomyelitis compared with that in patients receiving other antimicrobials was studied. A comparative case review was conducted of home infusion patients receiving cefepime and patients receiving other...

  • Antifungal prophylaxis in chemotherapy-associated neutropenia: a retrospective, observational study. Riedel, Amy; Choe, Lan; Inciardi, John; Yuen, Courtney; Martin, Thomas; Guglielmo, B Joseph // BMC Infectious Diseases;2007, Vol. 7 Issue 1, p70 

    Background: In August 2002, the antifungal prophylaxis algorithm for neutropenic hematology/oncology (NHO) patients at the Medical Center was changed from conventional amphotericin (AMB) to an azole (AZ) based regimen (fluconazole [FLU] in low-risk and voriconazole [VOR] in high-risk patients)....

  • Executive Summary: Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious Diseases Society of America. Freifeld, Alison G.; Bow, Eric J.; Sepkowitz, Kent A.; Boeckh, Michael J.; Ito, James I.; Mullen, Craig A.; Raad, Issam I.; Rolston, Kenneth V.; Young, Jo-Anne H.; Wingard, John R. // Clinical Infectious Diseases;2/15/2011, Vol. 52 Issue 4, p427 

    This document updates and expands the initial Infectious Diseases Society of America (IDSA) Fever and Neutropenia Guideline that was published in 1997 and first updated in 2002. It is intended as a guide for the use of antimicrobial agents in managing patients with cancer who experience...

  • Outpatient treatment with intravenous antimicrobial therapy and oral levofloxacin in patients with febrile neutropenia and hematological malignancies. Bellesso, Marcelo; Costa, Silvia Figueiredo; Pracchia, Luis Fernado; Santos Dias, Lucia Cristina; Chamone, Dalton; Dorlhiac-Llacer, Pedro Enrique // Annals of Hematology;Apr2011, Vol. 90 Issue 4, p455 

    The purpose of this study was to evaluate outcomes such as success of the initial therapy, failure of outpatient treatment, and death in outpatient treatment during intravenous antimicrobial therapy in patients with febrile neutropenia (FN) and hematological malignancies. In addition, clinical...

  • Itraconazole effective in treating wide range of fungal infections.  // Geriatrics;Feb1993, Vol. 48 Issue 2, p28 

    This article reports that the oral antifungal agent itraconazole (Sporanox) is effective against a wide range of opportunistic and endemic deep fungal infections. It was revealed by clinical studies presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy, Anaheim,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics