Protocolo diagnóstico y tratamiento empírico de la infección sin focalidad en el paciente neutropénico
- Falcón Abad, R. 1
- Íñigo Pestaña, M. 1
- Pérez García, A. 1
- 1 Servicio de Microbiología Clínica y Parasitología, Clínica Universidad de Navarra, Madrid, España
ISSN: 0304-5412
Año de publicación: 2022
Título del ejemplar: Enfermedades infecciosas (VIII)
Serie: 13
Número: 56
Páginas: 3308-3311
Tipo: Artículo
Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado
Resumen
Neutropenic patients are at particularly high risk of infection, with fever being the only sign they present with in the majority of cases. An etiological diagnosis is made in just 20% to 30% of febrile episodes. Early diagnosis and effective treatment are crucial for decreasing morbidity and mortality in this population. The treatment of fever in neutropenic patients includes intravenous beta-lactam antibiotics such as cefepime. Multidrug-resistant pathogens are emerging and there are few new anti-infectious agents being developed. Therefore, a rational use of antimicrobial agents is fundamental.
Referencias bibliográficas
- Taplitz RA, Kennedy EB, Bow EJ, Crews J, Gleason C, Hawley DK. Outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America clinical practice guideline update. J Clin Oncol. 2018;36(14):1443-53.
- Hansen BA, Wendelbo Ø, Bruserud Ø, Hemsing AL, Mosevoll KA, Reikvam H. Febrile neutropenia in acute leukemia. Epidemiology, etiology, pathophysiology and treatment. Mediterr J Hematol Infect Dis. 2020;12(1):e2020009.
- Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2011;52(4):e56-93.
- Heinz WJ, Buchheidt D, Christopeit M, von Lilienfeld Toal M, Cornely OA, Einsele H. Diagnosis and empirical treatment of fever of unknown origin (FUO) in adult neutropenic patients: guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Hematol. 2017;96(11):1775-92.
- Gudiol C, Aguilar Guisado M, Azanza JR, Candel FJ, Cantón R, Carratalà J. Executive summary of the consensus document of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), the Spanish Network for Research in Infectious Diseases (REIPI) and the Spanish Society of Haematology and Haemotherapy (SEHH) on the management of febrile neutropenia in patients with hematological malignancies. Enferm Infecc Microbiol Clin (Engl Ed). 2020;38(4):174-81.
- Nucci M. How I treat febrile neutropenia. Mediterr J Hematol Infect Dis. 2021;13(1):e2021025.