Q01. What are the most important factors relating to antibiotic management of febrile neutropenia?
Summary: Choosing the best antibiotic to use when treating febrile neutropenia requires consideration of a number of factors. First, it is necessary that the agent administered is active against all likely pathogens, including Gram-positive (Staphylococci, Streptococci, Enterococcus, viridans streptococci) and Gram-negative bacteria (Pseudomonas, Enterobacteriaceae). In addition, it is important to assess individual host risk factors, looking at the specific site of infection, and whether the infection is localized or systemic. Patients also need to be stratified according to their individual overall risk profile. By stratifying patients into high or low risk, the physician is able to tailor the treatment both in terms of type of antimicrobial used, as well as whether they are to be treated with oral or parenteral therapy.