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Empirie Antibacterial Therapy in Granulocytopenia Induced by Cancer Chemotherapy

ROBERT H. RUBIN, M.D.
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Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts


Ann Intern Med. 1988;108(1):134-136. doi:10.7326/0003-4819-108-1-134
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For the past two decades the empiric initiation of broad-spectrum antimicrobial therapy at the first sign of possible infection (unexplained fever, rigors, tachypnea, or acidosis) has been the cornerstone of managing infections in patients with cancer and chemotherapy-induced granulocytopenia. Such an approach produces a clinical response in approximately 75% of patients, whether or not infection is documented microbiologically (infection is documented in approximately 20% of febrile episodes). Early therapy before tissue infection enters the bloodstream, is believed to result in less morbidity and mortality than if therapy is delayed until blood culture results turn positive or focal findings appear (1-3).

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