Antibiotic prophylaxis in hematooncological patients - expert recommendation with the support of CELL, CHS and COS CLS JEP, S. CH. S. SLS
Abstract
Bacterial infections are potentially life-threatening complication in patients with febrile neutropenia (FN) after anticancer chemotherapy. Randomized controlled trials on fluoroquinolone (FQ) prophylaxis provided the evidence of usefulness of such an approach in reducing the rate of febrile episodes, the rate of microbiologically documented infections, the rate of Gramnegative and Gram-positive infections, and meta-analyses proved the influence on reducing all-cause and infection-related mortality.
Between the most risky patients ("high risk"), to whom prophylaxis brings the highest benefit, are those with expected long lasting (> 7 days) and profound absolute granulocytopenia (< 0.1 x 109/l), seen mainly in patients with acute leukemia (AL) and in hematopoietic stem cell transplant (HSCT) recipients.