Hépato-Gastro & Oncologie Digestive


Management of fever in neutropenic adult patients with cancer Volume 26, supplement 1, Octobre 2019


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1 CHU Rennes, Hôpital Pontchaillou, Service des maladies infectieuses et réanimation médicale, 2 rue Henri Le Guilloux, 35033 Rennes cedex
2 CHU Rennes, Hôpital Pontchaillou, CIC-Inserm 1414, Equipe interaction hôte-pathogène, Rennes
3 Université de Rennes, Inserm, Bacterial Regulatory RNAs and Medicine, UMR 1230, F-35000 Rennes
* Correspondance

Although less frequent and severe than in hematological setting, febrile neutropenia (FN) is one of the most feared complication following chemotherapy for solid cancer. Its management has to be stereotyped: i) early detection of life-threatening organ dysfunction; ii) complete history and physical examination to identify infectious foci and systematic blood-cultures sample; iii) administration of the first dose of empirical antibiotherapy within the first hour after initial presentation; iv) identification of patients candidates for outpatient management. An oral fluoroquinolone plus amoxicillin/clavulanate is recommended as empirical outpatient therapy. Different types of antibiotic treatments are recommended for hospitalized patients, according to the patients’ clinical presentation. Whether they are hospitalized or not, patients’ clinical condition must be reassessed regularly in order to adapt the antimicrobial therapy if they remain febrile. Thanks to this systematic approach, management of patients with NF can be perfectly safe even for patients eligible for outpatient management.

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