Author/Editor		Mlakar, Uroš
Title		Zdravljenje okužb pri hematološkem bolniku s hudo nevtropenijo
Translated title		Treatment of infections in patients with haematological disease and severe neutropenia
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 35, št. Suppl 7
Publication year		1996
Volume		str. 63-9
Language		slo
Abstract		In neutropenic patients fever may be the only manifestation of infection. Bacterial infection can be rapidly progressive and fatal if untreated. It is important to begin with empirical broad-spectrum antibiotics when fever is first detected. The criteria for starting empirical antibiotic therapy is a single rise in temperature to above 38.5 oC or a rise to 38 o C for two hours. The most commonly used regimen consists of a combination of a third-generation cephalosporin and an aminoglycoside. When infections do not respond after 72 hours of treatment, modifications of the antibiotic regimen are required. Usually vancomycin is added and aminoglycoside excluded from the regimen. In febrile patients who are on prophylaxis with quinolones the empirical therapy is started with combination of a third-generation cephalosporin and vancomycin. When the fever persists for more than 7 days while the patient is still neutropenic, or recrudesces after 7 days, amphotericin should be added to the antibacterial regimen. The author also describes how different clinical events and results of cultures suggest the need for a change in the empirical antimicrobal regimen.
Descriptors		HEMATOLOGIC DISEASES NEUTROPENIA INFECTION FEVER