BACKGROUND To compare vancomycin pharmacokinetic parameters in patients with and without neutropenia. METHODS Patients ≥18 years admitted on general wards were included. Routinely vancomycin trough and peak plasma concentrations were measured with a fluorescence polarization immunoassay. Pharmacokinetic parameters of individual patients were determined with maximum a posterior Bayesian estima...

BACKGROUND Neutropenic enterocolitis is a life-threatening complication most frequently occurring after intensive chemotherapy in acute leukaemias. Gramnegative bacteria constitute the most important group of causative pathogens. Fungi have also been reported, but their practical relevance remains unclear. The guidelines do not address concrete treatment recommendations for fungal neutropenic e...

Few data are available concerning the relationship between alveolar and blood cell populations during neutropenia. We wanted to compare the value of pulmonary endoscopic procedures with lavage in neutropenic (polymorphonuclear (PMN) count < or = 1,000.mm-3) and non-neutropenic settings. We therefore, retrospectively, reviewed the results of 118 investigations for pneumonia in patients with mali...

The following aspects of the management of patients with granulocytopenia and fever are reviewed in this article: adaptation of initial antibiotic regimens to the recent changes in the most common causative pathogens (namely a change from Gram-negative bacteria to Gram-positive bacteria and fungi); subsequent modifications of the empirically administered treatments; improvement of the host's de...

PURPOSE The objectives of the analysis were to characterize the time course of neutropenia after pemetrexed administration using an established semimechanistic-physiologic model, characterize the relationship between pemetrexed exposure and neutropenia, and describe differences in neutropenic response by vitamin supplementation status and between Japanese and Western patients. EXPERIMENTAL DE...

BACKGROUND Cost of neutropenic complications of myelosuppressive chemotherapy has been reported to be substantial. Prior research, however, has focused on initial hospitalization only and has failed to account for follow-on care. PATIENTS AND METHODS Using a US health-care claims database, all adult cancer patients who received a course of chemotherapy were identified. For each such patient, ...

STUDY OBJECTIVES Neutrophils often have been involved in the pathophysiology of ARDS. However, authentic ARDS has been described in patients with severe neutropenia, suggesting the presence of other potential mechanisms that are responsible of this syndrome. Alveolar macrophages (AMs) could be involved in the development of ARDS, and so we decided to study AM activation in neutropenic patients....

BACKGROUND Neutropenic fever is one of the most serious adverse effects of cancer chemotherapy. Neutropenia may cause a life-threatening bacterial infection. Therefore, febrile neutropenic inpatients are empirically treated with intravenous broad-spectrum antibiotics. Recently, several studies have suggested the presence of low-risk groups among febrile neutropenic patients. METHODS A prospec...

Invasive aspergillosis has been mainly reported among immunocompromised patients during prolonged periods of neutropenia. Recently, however, non-neutropenic patients in the ICU population have shown an increasing risk profile for aspergillosis. Associations with chronic obstructive pulmonary disease and corticosteroid therapy have been frequently documented in this cohort. Difficulties in achie...

The neutropenic diet historically has been a mainstay in oncology practice, with many providers continuing to adhere tightly to the diet for patients with neutropenia. However, clinically sound evidence remains limited and weak and does not support the diet as a foundation for policy and practice. Therefore, two questions remain: Does evidence exist to support the effectiveness of the neutropen...