Nucci Marcio, Arrais-Rodrigues Celso, Bergamasco Maria Daniela, Garnica Marcia, Gloria Ana Beatriz Firmato, Guarana Mariana, Machado Clarisse, Ramos Jessica, Salvino Marco Aurelio, Simões Belinda
Department of Internal Medicine, Hospital Universitário, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Grupo Oncoclinicas, Rio de Janeiro, Brazil.
Department of Clinical and Experimental Oncology, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil; Hospital Nove de Julho, Rede DASA, São Paulo, Brazil.
Hematol Transfus Cell Ther. 2024 Dec;46 Suppl 6(Suppl 6):S346-S361. doi: 10.1016/j.htct.2024.11.119. Epub 2024 Dec 18.
Febrile neutropenia is a major complication of the treatment of patients with hematologic diseases. Recent epidemiologic changes, with an increase in infection caused by drug-resistant bacteria, represent a major challenge for the proper management of febrile neutropenia. The impact of these changes in the epidemiology of infection may vary according to the region. In this document we present recommendations from the Infectious Diseases Committee of the Brazilian Association of Hematology, Blood Transfusion and Cell Therapy (ABHH) for the management of febrile neutropenia in hematologic patients. The consensus was developed by ten experts in the field, using the Delphi methodology. In the document we provide recommendations for the initial workup, prophylaxis, empiric antibiotic and antifungal therapy, modifications in the empiric regimen and criteria for discontinuing antimicrobial therapy.
发热性中性粒细胞减少是血液系统疾病患者治疗中的主要并发症。近期流行病学变化，耐药菌引起的感染增加，这对发热性中性粒细胞减少的恰当管理构成重大挑战。这些感染流行病学变化的影响可能因地区而异。在本文中，我们展示了巴西血液学、输血与细胞治疗协会（ABHH）传染病委员会关于血液学患者发热性中性粒细胞减少管理的建议。该共识由该领域的十位专家采用德尔菲法制定。本文提供了关于初始检查、预防、经验性抗生素和抗真菌治疗、经验性治疗方案的调整以及停止抗菌治疗标准的建议。
