Empirical antibiotics for febrile neutropenic cancer patients

The empirical institution of broad spectrum antibiotics for febrile neutropenic cancer patients has become standard medical practice. Traditionally, the antibiotics consisted of a combination of agents selected to maximize activity against the most commonly isolated pathogens, and often employed agents with synergistic antimicrobial activity. Recent additions to the antibiotic armamentarium, however, have provided single agents with equivalent spectra of activity, thus potentially allowing a 'monotherapeutic' alternative to the combination regimens. The empirical utilization of antibiotics for the febrile, neutropenic episode is reviewed, with emphasis on recent clinical studies evaluating select monotherapeutic 'agents'.