Klin Farmakol Farm. 2007;21(2):67-73

Fever of Unknown Origin in Patients with Neutropenia (so-called Febrile Neutropenia)

Petr Cetkovský

Klinický úsek, Ústav hematologie a krevní transfuze, Praha

In recent 30 years we were able to reduce mortality of the patients with febrile neutropenia (fever of unknown origin – FUO). This was particularly due to modern antiinfective drugs, new diagnostic tools, new prognostic models enabeling risk stratification of the patients. There has been developed new guidelines for quick therapy initiation. So antibiotics (ATBs), which are still basic stone of FUO treatment, can be promply and aproprietly administered. This is really important in fact, that FUO is one of the most important and emergent situation in very hematologic patients. There is also one important change in the politics of ATB administration in recent year, which mean, that glycopeptide ATBs are used only after proper cultivation, not just in persistent fever. To our advantage, now we have got new ATBs and antimycotics, which are less toxic and more eficatious. In context with modern ATBs, there is wide range of new multiresistant nosocomial flora, which is really increasing problem. We hope, that in future, there would be new rapid laboratory tests, that would not only be based on cultivation method. And due to this test we could have been able to detect mainly mycotic infection and treat this infection in pre-emptive, not only empiric way. Despite of progress in this field, there is still much to do in diagnosis and treatment of FUO.

Keywords: febrile neutropenia, granulocytopenia, antiinfective treatment, glycopeptide ATBs, antimycotics, multiresistant nosocomial flora, empiric therapy, pre-emptive therapy

Published: October 1, 2007  Show citation