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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: The strategy of antibiotic use in critically ill neutropenic patients | Legrand et al. Annals of Intensive Care 2011 1 22 http www.annalsofintensivecare.eom content 1 1 22 Ù Annals of Intensive Care a SpringerOpen Journal REVIEW Open Access The strategy of antibiotic use in critically ill neutropenic patients 1.2 2 2 2 3 Matthieu Legrand Adeline Max Benoit Schlemmer Elie Azoulay and Bertrand Gachot Abstract Suspicion of sepsis in neutropenic patients requires immediate antimicrobial treatment. The initial regimen in critically ill patients should cover both Gram-positive and Gram-negative pathogens including Pseudomonas aeruginosa. However the risk of selecting multidrug-resistant pathogens should be considered when using broadspectrum antibiotics for a prolonged period of time. The choice of the first-line empirical drugs should take into account the underlying malignancy local bacterial ecology clinical presentation and severity of acute illness. This review provides an up-to-date guide that will assist physicians in choosing the best strategy regarding the use of antibiotics in neutropenic patients with a special focus on critically ill patients based on the above-mentioned considerations and on the most recent international guidelines and literature. Introduction Neutropenia is defined as a neutrophil count 500 mm3 or 1000 mm3 with a predicted decrease to 500 mm3 1 2 . Infection remains a major complication of neutropenia and severe sepsis and septic shock are associated with high hospital mortality 3 4 . Fever defined as a single oral temperature 38.3 C or 38.0 C for at least 1 hour develops in 10-50 of patients after chemotherapy for solid tumors and in more than 80 of patients with hematological malignancies 5 . Urgent and appropriate antibiotic administration is mandatory to prevent further clinical deterioration especially in critically ill patients with signs of respiratory distress or severe sepsis. Therefore the first-line antibiotics should cover the pathogens deemed to be most likely based on the patient s characteristics
