The changing face of febrile neutropenia-from monotherapy to moulds to mucositis. Why monotherapy?

Abstract

This is an account of the history of the early days of monotherapy of infections in neutropenic patients with haematological malignancies. A chance encounter with Ben de Pauw led to his introduction to clinical drug development research, introduced him to Peter Donnelly who was studying ceftazidime at the Hammersmith Hospital in London and led to a series of collaborative studies at the start of a distinguished research career. This paper is dedicated to Ben de Pauw and also to the memory of my mentor, Roy Foord, who had the vision to go against his initial cautious instinct and allow me to convince him of the merits of these studies when combinations including aminoglycosides were standard. These initial studies also contributed to the concept of initial empirical monotherapy with re-appraisal at 48-72 h.