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Evidence-Based Guidelines for Empirical Therapy of Neutropenic Fever in Korea

Authors
 Dong-Gun Lee  ;  Sung-Han Kim  ;  Soo Young Kim  ;  Chung-Jong Kim  ;  Wan Beom Park  ;  Young Goo Song  ;  Jung-Hyun Choi 
Citation
 KOREAN JOURNAL OF INTERNAL MEDICINE, Vol.26(2) : 220-252, 2011 
Journal Title
KOREAN JOURNAL OF INTERNAL MEDICINE
ISSN
 1226-3303 
Issue Date
2011
MeSH
Anti-Bacterial Agents/administration & dosage* ; Antibiotic Prophylaxis/standards* ; Antifungal Agents/administration & dosage* ; Drug Administration Schedule ; Evidence-Based Medicine ; Fever/diagnosis ; Fever/drug therapy* ; Fever/etiology ; Humans ; Neutropenia/diagnosis ; Neutropenia/drug therapy* ; Neutropenia/etiology ; Republic of Korea ; Time Factors ; Treatment Outcome
Keywords
Practice guideline ; Neutropenia ; Fever ; Korea
Abstract
Neutrophils play an important role in immunological function. Neutropenic patients are vulnerable to infection, and except fever is present, inflammatory reactions are scarce in many cases. Additionally, because infections can worsen rapidly, early evaluation and treatments are especially important in febrile neutropenic patients. In cases in which febrile neutropenia is anticipated due to anticancer chemotherapy, antibiotic prophylaxis can be used, based on the risk of infection. Antifungal prophylaxis may also be considered if long-term neutropenia or mucosal damage is expected. When fever is observed in patients suspected to have neutropenia, an adequate physical examination and blood and sputum cultures should be performed. Initial antibiotics should be chosen by considering the risk of complications following the infection; if the risk is low, oral antibiotics can be used. For initial intravenous antibiotics, monotherapy with a broad-spectrum antibiotic or combination therapy with two antibiotics is recommended. At 3-5 days after beginning the initial antibiotic therapy, the condition of the patient is assessed again to determine whether the fever has subsided or symptoms have worsened. If the patient's condition has improved, intravenous antibiotics can be replaced with oral antibiotics; if the condition has deteriorated, a change of antibiotics or addition of antifungal agents should be considered. If the causative microorganism is identified, initial antimicrobial or antifungal agents should be changed accordingly. When the cause is not detected, the initial agents should continue to be used until the neutrophil count recovers
Files in This Item:
T201194023.pdf Download
DOI
10.3904/kjim.2011.26.2.220
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/95329
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