Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious Diseases Society of America
- Study type
- Clinical guideline
- Study name
- IDSA Fever and Neutropenia Guideline 2010
- Design
- Clinical guideline (update of the Infectious Diseases Society of America fever and neutropenia guideline)
- Source
- Clinical Infectious Diseases · 2011
In plain words
Sometimes in people with cancer who are having chemotherapy, the number of white blood cells (which fight infection) falls and a fever develops. This is called "fever and neutropenia" and can be dangerous. This guideline stresses that in this situation antibiotic treatment must be started straight away. The doctor first assesses each patient's risk of infection. If you get a fever during chemotherapy, tell your doctor or treatment centre immediately.
Key guideline recommendations
- The level of recommendation is not given in the abstract
Risk stratification is the recommended starting point for managing patients with fever and neutropenia; neutropenic patients are classified as at high or low risk of infection based on the signs and symptoms at presentation, the underlying cancer, the type of treatment and medical comorbidities.
- The level of recommendation is not given in the abstract
All patients presenting with fever and neutropenia should be treated promptly with broad-spectrum antibiotics covering gram-positive and gram-negative pathogens (the indication for immediate empirical antibiotic therapy has not changed).
Study population
Patients with cancer who develop chemotherapy-induced fever and neutropenia. Further details are not given in the abstract.
Endpoints
This document is a guideline and has no trial endpoint. Its aim is to provide guidance on the use of antimicrobial agents in the management of patients with cancer who develop chemotherapy-induced fever and neutropenia.
Safety and side effects
No information on adverse events is reported in the abstract.
Clinical significance and place in guidelines
Based on the abstract, this guideline makes risk stratification (high risk or low risk) the starting point for managing fever and neutropenia and emphasises prompt broad-spectrum antibiotic treatment covering gram-positive and gram-negative organisms. It also defines more clearly the populations that benefit most from antibacterial, antifungal and antiviral prophylaxis. Because the guideline was developed in a North American setting, its application in each country should take into account local patterns of pathogens and antimicrobial resistance. Whether the guideline is current and endorsed in newer guidelines should be checked separately.
Limitations
All panel members are from institutions in the United States or Canada, and the guideline was developed in the context of North American clinical practice. Some recommendations may be less applicable in regions with differences in available antibiotics, predominant pathogens and/or healthcare-related economic conditions. In addition, algorithms for empirical or pre-emptive antifungal treatment are still evolving.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.