Approach to fever in patients with neutropenia: a review of diagnosis and management
Febrile neutropenia (FN) is associated with mortality rates as high as 40%, highlighting the importance of appropriate clinical management in this patient population. The morbidity and mortality of FN can be attributed largely to infectious processes, with specific concern for infections caused by p...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-11-01
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| Series: | Therapeutic Advances in Infectious Disease |
| Online Access: | https://doi.org/10.1177/20499361221138346 |
| _version_ | 1811303984178135040 |
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| author | J. Myles Keck Mary Joyce B. Wingler David A. Cretella Prakhar Vijayvargiya Jamie L. Wagner Katie E. Barber Tulip A. Jhaveri Kayla R. Stover |
| author_facet | J. Myles Keck Mary Joyce B. Wingler David A. Cretella Prakhar Vijayvargiya Jamie L. Wagner Katie E. Barber Tulip A. Jhaveri Kayla R. Stover |
| author_sort | J. Myles Keck |
| collection | DOAJ |
| description | Febrile neutropenia (FN) is associated with mortality rates as high as 40%, highlighting the importance of appropriate clinical management in this patient population. The morbidity and mortality of FN can be attributed largely to infectious processes, with specific concern for infections caused by pathogens with antimicrobial resistance. Expeditious identification of responsible pathogens and subsequent initiation of empiric antimicrobial therapy is imperative. There are four commonly used guidelines, which have variable recommendations for empiric therapy in these populations. All agree that changes could be made once patients are stable and/or with an absolute neutrophil count (ANC) over 500 cells/mcL. Diagnostic advances have the potential to improve knowledge of pathogens responsible for FN and decrease time to results. In addition, more recent data show that rapid de-escalation or discontinuation of empiric therapy, regardless of ANC, may reduce days of therapy, adverse effects, and cost, without affecting clinical outcomes. Antimicrobial and diagnostic stewardship should be performed to identify, utilize, and respond to appropriate rapid diagnostic tests that will aid in the definitive management of this population. |
| first_indexed | 2024-04-13T07:57:58Z |
| format | Article |
| id | doaj.art-41dfca69a4514510b060cb04906e65f3 |
| institution | Directory Open Access Journal |
| issn | 2049-937X |
| language | English |
| last_indexed | 2024-04-13T07:57:58Z |
| publishDate | 2022-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Infectious Disease |
| spelling | doaj.art-41dfca69a4514510b060cb04906e65f32022-12-22T02:55:21ZengSAGE PublishingTherapeutic Advances in Infectious Disease2049-937X2022-11-01910.1177/20499361221138346Approach to fever in patients with neutropenia: a review of diagnosis and managementJ. Myles KeckMary Joyce B. WinglerDavid A. CretellaPrakhar VijayvargiyaJamie L. WagnerKatie E. BarberTulip A. JhaveriKayla R. StoverFebrile neutropenia (FN) is associated with mortality rates as high as 40%, highlighting the importance of appropriate clinical management in this patient population. The morbidity and mortality of FN can be attributed largely to infectious processes, with specific concern for infections caused by pathogens with antimicrobial resistance. Expeditious identification of responsible pathogens and subsequent initiation of empiric antimicrobial therapy is imperative. There are four commonly used guidelines, which have variable recommendations for empiric therapy in these populations. All agree that changes could be made once patients are stable and/or with an absolute neutrophil count (ANC) over 500 cells/mcL. Diagnostic advances have the potential to improve knowledge of pathogens responsible for FN and decrease time to results. In addition, more recent data show that rapid de-escalation or discontinuation of empiric therapy, regardless of ANC, may reduce days of therapy, adverse effects, and cost, without affecting clinical outcomes. Antimicrobial and diagnostic stewardship should be performed to identify, utilize, and respond to appropriate rapid diagnostic tests that will aid in the definitive management of this population.https://doi.org/10.1177/20499361221138346 |
| spellingShingle | J. Myles Keck Mary Joyce B. Wingler David A. Cretella Prakhar Vijayvargiya Jamie L. Wagner Katie E. Barber Tulip A. Jhaveri Kayla R. Stover Approach to fever in patients with neutropenia: a review of diagnosis and management Therapeutic Advances in Infectious Disease |
| title | Approach to fever in patients with neutropenia: a review of diagnosis and management |
| title_full | Approach to fever in patients with neutropenia: a review of diagnosis and management |
| title_fullStr | Approach to fever in patients with neutropenia: a review of diagnosis and management |
| title_full_unstemmed | Approach to fever in patients with neutropenia: a review of diagnosis and management |
| title_short | Approach to fever in patients with neutropenia: a review of diagnosis and management |
| title_sort | approach to fever in patients with neutropenia a review of diagnosis and management |
| url | https://doi.org/10.1177/20499361221138346 |
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