Indicaciones para la prevención de infecciones en el paciente inmunocomprometido

  1. Falcón Abad, R. 1
  2. Pérez García, A. 1
  3. Íñigo Pestaña, M. 1
  1. 1 Servicio de Microbiología Clínica y Parasitología, Clínica Universidad de Navarra, Madrid, España
Journal:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Year of publication: 2022

Issue Title: Enfermedades infecciosas (VIII)

Series: 13

Issue: 56

Pages: 3322-3326

Type: Article

DIALNET GOOGLE SCHOLAR

More publications in: Medicine: Programa de Formación Médica Continuada Acreditado

Abstract

A total of 48% to 60% of immunosuppressed patients may have a febrile episode, fever, or established or hidden infection. However, the use of antibiotics as a prophylactic measure continues to be controversial due to the worrying rise in bacterial resistance, changes that occur in the host's microbiota, and drug interactions they may cause. European and American recommendations agree on the choice of fluoroquinolones as prophylaxis in immunosuppressed patients with neutropenia that has been ongoing for more than seven days. In addition to an effective prophylaxis strategy, early diagnosis is fundamental for rapid, effective treatment.

Bibliographic References

  • Gafter Gvili A, Fraser A, Paul M, Vidal L, Lawrie TA, van de Wetering MD. Antibiotic prophylaxis for bacterial infections in afebrile neutropenic patients following chemotherapy. Cochrane Database Syst Rev. 2012;1:CD004386.
  • McCarthy MW, Walsh TJ. Prophylactic measures during induction for acute myeloid leukemia. Curr Oncol Rep. 2017;19(3):18.
  • McGrath B, Broadhurst M, Roman C. Infectious disease considerations in immunocompromised patients. JAAPA. 2020;33(9):16-25.
  • Classen AY, Henze L, von Lilienfeld-Toal M, Maschmeyer G, Sandherr M, Graeff LD. Primary prophylaxis of bacterial infec- tions and Pneumocystis jirovecii pneumonia in patients with hematologic malignancies and solid tumors: 2020 updated guidelines of the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology (AGIHO/DGHO). Ann Hematol. 2021;100(6):1603-20.
  • Pizzo PA. Management of patients with fever and neutropenia through the arc of time: A narrative review: A narrative review. Ann Intern Med. 2019;170(6):389-97.
  • Rubin RH, Schaffner A, Speich R. Introduction to the Immunocompromised Host Society consensus conference on epidemiology, prevention, diagnosis, and management of infections in solid-organ transplant patients. Clin Infect Dis. 2001;33Suppl1(s1):S1-4.
  • Schnell D, Azoulay E, Benoit D, Clouzeau B, Demaret P, Ducassou S. Management of neutropenic patients in the intensive care unit (new-borns excluded) recommendations from an expert panel from the French Intensive Care Society (SRLF) with the French Group for Pediatric Intensive Care Emergencies (GFRUP), the French Society of Anesthesia and Intensive Care (SFAR), the French Society of Hematology (SFH), the French Society for Hospital Hygiene (SF2H), and the French Infectious Diseases Society (SPILF). Ann Intensive Care. 2016; 6(1):90.
  • 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.
  • Dropulic LK, Lederman HM. Overview of infections in the immunocompromised host. En: Diagnostic microbiology of the immu- nocompromised host. Washington, DC: ASM Press; 2016. p. 1-509.
Data source: Dialnet