INITIAL EMPIRICAL ANTIBIOTIC-THERAPY FOR NEUTROPENIC FEVER - ANALYSISOF THE CAUSES OF DEATH

We have reviewed the records of all patients who were included in EORT C-IATCG protocols for the empirical treatment of febrile neutropenia a t the Institut Jules Bordet from 1984 to 1994. Of the 410 granulocytop enic patients, 49 died during or after febrile neutropenia. Among thes e, 19 died from infection, 18 from progressive neoplasia, and 12 from other causes. Fatal bacterial infection occurred in 10 patients and ar ose during the first 10 days; fatal fungal infection occurred in 7 pat ients, all of whom had a profound and protracted granulocytopenia (pol ymorphoneutrophil count <100/mm(3) for more than 20 days). In comparis on with a previous similar study (1974-1983) our present observations shows a decrease of overall mortality during or after febrile neutrope nia and an increase of gram-positive microorganisms and fungal pathoge ns as a cause for infectious deaths.