USING GLYCOPEPTIDES IN FEBRILE NEUTROPENI C ADULTS

Glycopeptides should not be prescribed as a first-line therapy in adul ts with febrile neutropenia, except in patients with presumed severe i nfection due to Gram positive bacteria. Trough serum levels should be monitored because of increased clearance and/or distribution volume de scribed with such antibiotics, Both vancomycin and teicoplanin are equ ally effective in the management of Gram positive bacterial infections in this setting; teicoplanin seems to be better tolerated according t o several studies. The easy administration of teicoplanin may facilita te the outpatient management of neutropenic adults with confirmed Gram positive infections, The global cost of such treatments has to be ana lyzed and the epidemiology of Gram positive bacteria resistance to gly copeptides should be carefully monitored in hematology units.