Antoniadou Anastasia, Giamarellou Helen
University General Hospital ATTIKON, Fourth Department of Internal Medicine, 1 Rimini Street, 12462 Athens, Greece.
Infect Dis Clin North Am. 2007 Dec;21(4):1055-90, x. doi: 10.1016/j.idc.2007.08.008.
Febrile neutropenia is a syndrome commonly anticipated in patients receiving treatment for cancer. Its management for the last three decades has included the prompt administration of empiric antibacterial therapy, which resulted in a reduction in mortality. Challenges remain the administration of the most appropriate empiric treatment regimen adapted to evolving and changing epidemiology of infections in neutropenic patients and resistance rates; the development of markers of early diagnosis of severe bacterial or fungal infections; the risk stratification of patients; the establishment of targeted empiric (preemptive) antifungal therapy criteria; and the containment of antimicrobial resistance that compromises effective treatment efforts, through effective antibiotic policies and implementation of infection control measures, especially hand hygiene. The need for targeted antimicrobial or antifungal prophylaxis and supportive strategies like the use of growth factors awaits further clarification.
发热性中性粒细胞减少是癌症治疗患者中常见的一种综合征。在过去三十年中，其治疗方法包括迅速给予经验性抗菌治疗，这使得死亡率有所降低。目前仍存在诸多挑战，包括采用适应中性粒细胞减少患者感染流行病学变化及耐药率变化的最合适经验性治疗方案；开发严重细菌或真菌感染的早期诊断标志物；对患者进行风险分层；制定针对性经验性（抢先）抗真菌治疗标准；通过有效的抗生素政策和感染控制措施（尤其是手卫生）来控制对抗菌治疗效果产生影响的抗菌药物耐药性。对于针对性抗菌或抗真菌预防以及使用生长因子等支持性策略的需求，还有待进一步明确。
