EARLY EMPIRIC ANTIBIOTIC-THERAPY FOR FEBRILE NEUTROPENIA PATIENTS AT LOW-RISK

Infection continues to be a frequent cause of morbidity in febrile neu tropenic patients. The risk of developing complications or of death is substantially different in various subsets of febrile neutropenic pat ients. Recently developed risk-assessment strategies have enabled clin icians to identify ''low-risk'' febrile neutropenic patients, based on a set of clinical criteria, at the onset of a febrile episode. Variou s therapeutic options including (1) early discharge from the hospital, (2) a switch from parenteral to oral antibiotic regimens, and (3) out patient parenteral and/or oral antibiotic therapy have been evaluated in these ''low-risk'' patients. Initial results are promising, and fur ther refinements in risk-assessment models and antimicrobial regimens are likely to make ambulatory management of low-risk febrile neutropen ic patients the new standard of care.