Viscoli Claudio, Varnier Oliviero, Machetti Marco
Infectious Disease Unit, University of Genova/National Institute for Cancer Research, 16132 Genova, Italy.
Clin Infect Dis. 2005 Apr 1;40 Suppl 4:S240-5. doi: 10.1086/427329.
Determinations of the type and setting of empirical therapy for immunocompromised patients with fever are complicated by the characteristics of the underlying illness and the effects of treatments already received, as well as by changing microbiological patterns and trends in drug resistance at national and institutional levels. Several systems have been proposed to distinguish patients who could benefit from outpatient antibiotic therapy from patients who require hospitalization. Practical considerations may decide whether the necessary monitoring during the period of neutropenia can be achieved.
对于免疫功能低下且发热的患者,确定经验性治疗的类型和方案会因基础疾病的特点、已接受治疗的影响,以及国家和机构层面微生物模式的变化和耐药趋势而变得复杂。已经提出了几种系统,以区分可从门诊抗生素治疗中获益的患者和需要住院治疗的患者。实际考虑因素可能决定在中性粒细胞减少期间能否进行必要的监测。