Академический Документы
Профессиональный Документы
Культура Документы
Randy A., et al. Antimicrobial Prophylaxis for Adult Patients With Cancer-Related Immunosuppression: ASCO and IDSA Clinical Practice
Guideline Update. J Clin Oncol 36:3043-3054.
Epidemiología
• Complicaciones más frecuentes y graves de la quimioterapia contra el
cáncer
• Morbilidad considerable, ya que entre el 20% y el 30% de los
pacientes presentan complicaciones que requieren tratamiento
hospitalario
• Mortalidad general hospitalaria del 10%
• Tasas de mortalidad del 18% G(-) y del 5% en bacteriemia G(+).
J. Klastersky, J. de Naurois, K. Rolston, et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Annals of Oncology 27
(Supplement 5): v111–v118, 2016
Etiología
Freifeld A. Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious
Diseases Society of America. Clinical Infectious Diseases 2011;52(4):e56–e93
Factores de Riesgo
• Enfermedad avanzada,
• Historial de FN anterior,
• No profilaxis antibiótica o estimulante de
colonias de granulocitos uso del factor (G-
CSF)
• Mucositis
• Mal estado
• Enfermedad cardiovascular
J. Klastersky, J. de Naurois, K. Rolston, et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Annals of Oncology 27
(Supplement 5): v111–v118, 2016
Clínica
J. Klastersky, J. de Naurois, K. Rolston, et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Annals of Oncology 27
(Supplement 5): v111–v118, 2016
Estadificación del riesgo
Randy A., et al. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology
and Infectious Diseases Society of America Clinical Practice Guideline Update. J Clin Oncol 36:3043-3054.
Estadificación del riesgo
0: bajo
1-2: intermedio
=>3: alto
ASCO and IDSA Clinical Practice Guideline Update. J Clin Oncol 36:3043-3054.
Freifeld A. Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious
Diseases Society of America. Clinical Infectious Diseases 2011;52(4):e56–e93
Tratamiento empírico
• Ceftazidima o Cefepime
• Imipenem o Meropenem
• Piperacilina/Tazobactam
Freifeld A. Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious
Diseases Society of America. Clinical Infectious Diseases 2011;52(4):e56–e93
Tratamiento oral
FLUROQUINO
LA + AMOXACILINA/
CLAVULANATO
CLINDAMICINA EN ALÉRGICOS
Randy A., et al. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology
and Infectious Diseases Society of America Clinical Practice Guideline Update. J Clin Oncol 36:3043-3054.
ASCO and IDSA Clinical Practice Guideline Update. J Clin Oncol 36:3043-3054.
Tratamiento Profiláctico
ASCO and IDSA Clinical Practice Guideline Update. J Clin Oncol 36:3043-3054.
Tratamiento Profiláctico
Profilaxis neutropenia
J. Klastersky, J. de Naurois, K. Rolston, et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Annals of Oncology 27
(Supplement 5): v111–v118, 2016