Challenges in febrile neutropenia

Febrile neutropenia is a common complication among hematologic patients. Bacteremia is the most frequently documented infectious cause and, in recent decades, there has been an epidemiological change with an increase in gram-negative bacilli (GNB) and multiresistance (MR).

In this context, empirical antibiotic treatment has become a challenge. Inadequate empirical antibiotic treatment (TAEI) has a direct impact on mortality. Therefore, my objective is to describe the epidemiology of febrile neutropenia and the current epidemiology of bacteremia in oncohematological patients, as well as resistance rates and the rate and impact of TAEI.

Provisional/expected results

Bacteremia is associated with mortality rates as high as 40%, and up to 16% of cases present with septic shock; which further increases mortality (55%). These high rates of mortality associated with bacteremia do not change in patients with HIV, who present similar mortality rates. Empirical treatment was inappropriate in up to 26.5% and the rates increase even more when dealing with multiresistant gram-negative bacilli, mainly Pseudomonas aeruginosa. Up to 34.7% of the large negative bacilli isolated in blood cultures are resistant to at least 1 of the antibiotics recommended in the guidelines to date.