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Published on: May 12, 2023
[Management of 315neutropenic febrile episodes in a cancer center]
H Dutronc1, M Billhot, M Dupon
1Fédération de maladies infectieuses et tropicales, hôpital Pellegrin-Tripode, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. herve.dutronc@chu-bordeaux.fr
Unlabelled:
Management of febrile neutropenic patients is described in guidelines. Each cancer center can adapt these according to its local bacterial ecology. We present a retrospective study made in a cancer center from 2001 to 2003.
Method:
Three hundred and fifteen febrile neutropenic episodes after chemotherapy (66% for solid tumor) were analysed.
Results:
For 279 episodes, no antibiotic therapy was given before admission. Clinical or radiological manifestations occurred in 46%; microbiologically documented infections by hemocultures in 28% (Gram positive: 42%; Gram negative: 51%) and by puncture in 14% (Gram negative: 58%). The length of pyrexia was inferior to 7 days in 88% and neutropenia inferior 7 days in 80.8%. 79.7% of episodes were treated with one of the three antibiotic therapy recommended by the center (ceftriaxone+tobramycin; ceftriaxone+ciprofloxacin; ceftriaxone+ofloxacin); 13.3% were treated with an other therapy; 7% received no antibiotic therapy. 68.5% of patients treated with one of the three antibiotic therapies, became afebrile without changing the antibiotic protocol.
Conclusion:
In our study, there were a majority of Gram negative bacteria except for Pseudomonas aeruginosa. The three antibiotic therapy recommended by the center (third generation cephalosporin+aminoglycosides or fluoroquinolones) were effective and glycopeptide was not necessary in first intention treatment.
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