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. 2011 Jun 15;1(1):22.
doi: 10.1186/2110-5820-1-22.

The strategy of antibiotic use in critically ill neutropenic patients

Matthieu Legrand  1 , Adeline Max, Benoît Schlemmer, Elie Azoulay, Bertrand Gachot
Affiliations

The strategy of antibiotic use in critically ill neutropenic patients

Matthieu Legrand et al. Ann Intensive Care. .

Abstract

Suspicion of sepsis in neutropenic patients requires immediate antimicrobial treatment. The initial regimen in critically ill patients should cover both Gram-positive and Gram-negative pathogens, including Pseudomonas aeruginosa. However, the risk of selecting multidrug-resistant pathogens should be considered when using broad-spectrum antibiotics for a prolonged period of time. The choice of the first-line empirical drugs should take into account the underlying malignancy, local bacterial ecology, clinical presentation and severity of acute illness. This review provides an up-to-date guide that will assist physicians in choosing the best strategy regarding the use of antibiotics in neutropenic patients, with a special focus on critically ill patients, based on the above-mentioned considerations and on the most recent international guidelines and literature.

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Figures

Figure 1
Figure 1
Suggested adjustments to the empirical antibiotic regimen in patients with persistent fever after 3-5 days treatment.
See this image and copyright information in PMC

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