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Management of fever in neutropenic adult patients with cancer

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2019. Sujet(s) : Ressources en ligne : Abrégé : Although less frequent and severe than in a hematological setting, febrile neutropenia (FN) is one of the most feared complications following chemotherapy for solid cancer. Its management must be systematic: i) early detection of life-threatening organ dysfunction; ii) full history and physical examination to identify the site of infection, and a blood culture test carried out; iii) administration of the first dose of empirical antibiotherapy within the first hour after initial presentation; iv) identification of patients suitable for outpatient management. An oral fluoroquinolone plus amoxicillin/clavulanate is recommended as empirical outpatient treatment. Different types of antibiotic treatments are recommended for hospitalized patients, depending on the patient in question's clinical presentation. Whether they are hospitalized or not, a patient's clinical condition must be reassessed regularly in order to adjust the antimicrobial therapy if they remain febrile. Thanks to this systematic approach, patients with NF receive treatment that is perfectly safe and as unrestrictive as possible, and may even be able to receive the treatment as outpatients.
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Although less frequent and severe than in a hematological setting, febrile neutropenia (FN) is one of the most feared complications following chemotherapy for solid cancer. Its management must be systematic: i) early detection of life-threatening organ dysfunction; ii) full history and physical examination to identify the site of infection, and a blood culture test carried out; iii) administration of the first dose of empirical antibiotherapy within the first hour after initial presentation; iv) identification of patients suitable for outpatient management. An oral fluoroquinolone plus amoxicillin/clavulanate is recommended as empirical outpatient treatment. Different types of antibiotic treatments are recommended for hospitalized patients, depending on the patient in question's clinical presentation. Whether they are hospitalized or not, a patient's clinical condition must be reassessed regularly in order to adjust the antimicrobial therapy if they remain febrile. Thanks to this systematic approach, patients with NF receive treatment that is perfectly safe and as unrestrictive as possible, and may even be able to receive the treatment as outpatients.

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