Don’t prescribe antibiotics to prevent infectious complications from neutropenia in cancer patients treated with standard dose chemotherapy.

Type of practice


Topic Area

Medical Oncology

The most frequent complication of chemotherapy is myelotoxicity with particular reference to the neutropenia. Neutropenia. is a serious cause of impairment of the immune system with the risk of infection, sepsis and septicemia. Normally the relevant pathogens are bacterial type, although you can not rule out viral or fungal infections. For many years it was considered indicated for prophylactic treatment with broad-spectrum antibiotics, such as quinolones. Today we know that there is no scientific evidence of the utility of this practice.
Antibiotic therapy is indicated only in febrile neutropenia (in immunocompromised patient is very serious event, often lethal) and in clinical infection without fever. In these cases is indicated to select antibiotic therapy only on the basis of an antibiogram. In case of clinical emergency selection of the antibiotic can be performed on the basis of clinical criteria waiting the antibiotic result. It is known that antibiotic therapy can stimulate allergic or anafilactic reactions and produce bacterial resistance, especially when used at a dose lower than recommended.


1. NCCN Guidelines Version 1.2013. NCCN Prevention and Treatment of Cancer-related Infections Guidelines.
2. Freifeld AG, et al. Clin Infect Dis 2011; 52:e56-93.

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