Onkológia 5/2020

Febrile neutropenia – view on antimicrobial stewardship in oncohaematology

Febrile neutropenia is the most common infectious complication in patients with haematological malignancy. Changes in epidemiology and increasing infections caused by resistant pathogens have not affect significantly the basic principles of diagnostic and therapeutic approach but emphasize the rational antibiotic treatment. Antimicrobial stewardship is a set of procedures focused on optimal antimicrobial therapy. The main objectives of stewardship are adequate, effective treatment reflecting the local epidemiology. Stratification of the patients according to their risk, strategy of initial empirical antimicrobial treatment using escalation or de-escalation, use of monotherapy or combination treatment, duration of therapy and strategy for treatment of secondary infections are the main tools of this stewardship. Formal or informal application of antimicrobial stewardship in daily practice increases quality of care in patients with hematological malignancy.

Keywords: febrile neutropenia, antimicrobial stewardship, de-escalation