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PABLO PARENTI NEUTROPENIA FEBRIL
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[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Evaluación del riesgo > 7 dias de duración - < 100 neutrofilos – comorbilidades – 21 puntos  MASCC
Inpatient versus outpatient—Forest plot of treatment failure. Teuffel O et al. Ann Oncol 2011;annonc.mdq745 © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com
Intravenous versus oral treatment in ambulatory care—Forest plot of treatment failure. Teuffel O et al. Ann Oncol 2011;annonc.mdq745 © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com
Scoring index for identification of low-risk febrile neutropenic patients at time of presentation with fever. Hughes W T et al. Clin Infect Dis. 2002;34:730-751 © 2002 by the Infectious Diseases Society of America
Estratificación de Riesgo al Ingreso  © 2009 Clínica-UNR.org
 
Exámenes complementarios ,[object Object],[object Object],[object Object]
Foco © 2009 Clínica-UNR.org
Infecciones Microbiológicamente Detectadas. Resultados Positivos  © 2009 Clínica-UNR.org
Hongos ,[object Object],[object Object]
Antibioticoterapia inicial
Common Bacterial Pathogens in Neutropenic Patients ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Initial management of fever and neutropenia. Freifeld A G et al. Clin Infect Dis. 2011;52:e56-e93 © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:journals.permissions@oup.com.
Indications for Addition of Antibiotics Active Against Gram-Positive Organisms to the Empirical Regimen for Fever and Neutropenia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cuanto tiempo ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Reassess after 2-4 days of empirical antibiotic therapy. Freifeld A G et al. Clin Infect Dis. 2011;52:e56-e93 © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:journals.permissions@oup.com.
High-risk patient with fever after 4 days of empirical antibiotics. Freifeld A G et al. Clin Infect Dis. 2011;52:e56-e93 © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:journals.permissions@oup.com.
Unica vs multiples dosis de aminoglucósidos ,[object Object],[object Object],[object Object]
Antigúngicos ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Antivirales ,[object Object],[object Object]
Factores crecimiento de colonias ,[object Object],[object Object]
cateter ,[object Object],[object Object],[object Object]
 
PABLO PARENTI [email_address] GRACIAS

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Neutropenia febril

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  • 6. Inpatient versus outpatient—Forest plot of treatment failure. Teuffel O et al. Ann Oncol 2011;annonc.mdq745 © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com
  • 7. Intravenous versus oral treatment in ambulatory care—Forest plot of treatment failure. Teuffel O et al. Ann Oncol 2011;annonc.mdq745 © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com
  • 8. Scoring index for identification of low-risk febrile neutropenic patients at time of presentation with fever. Hughes W T et al. Clin Infect Dis. 2002;34:730-751 © 2002 by the Infectious Diseases Society of America
  • 9. Estratificación de Riesgo al Ingreso © 2009 Clínica-UNR.org
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  • 12. Foco © 2009 Clínica-UNR.org
  • 13. Infecciones Microbiológicamente Detectadas. Resultados Positivos © 2009 Clínica-UNR.org
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  • 18. Initial management of fever and neutropenia. Freifeld A G et al. Clin Infect Dis. 2011;52:e56-e93 © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:journals.permissions@oup.com.
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  • 21. Reassess after 2-4 days of empirical antibiotic therapy. Freifeld A G et al. Clin Infect Dis. 2011;52:e56-e93 © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:journals.permissions@oup.com.
  • 22. High-risk patient with fever after 4 days of empirical antibiotics. Freifeld A G et al. Clin Infect Dis. 2011;52:e56-e93 © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:journals.permissions@oup.com.
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Editor's Notes

  1. En los pacientes de bajo riesgo se evalua ambulatorio vs internado, oral vs endovenoso. Se tratan de poblaciones heterogeneas con pocas complicaciones
  2. Inpatient versus outpatient—Forest plot of treatment failure. Squares to the left of the vertical line indicate a decreased risk of developing treatment failure in patients receiving inpatient management. Horizontal lines through the squares represent 95% confidence intervals (CIs). The diamonds represent the overall risk ratio (RR) from the meta-analyses and the corresponding 95% CIs.
  3. Intravenous versus oral treatment in ambulatory care—Forest plot of treatment failure. Squares to the left of the vertical line indicate a decreased risk in developing treatment failure in patients receiving intravenous antibiotics. Horizontal lines through the squares represent 95% CIs. The diamonds represent the overall risk ratio (RR) from the meta-analyses and the corresponding 95% confidence intervals. p.o. = oral.
  4. Scoring index for identification of low-risk febrile neutropenic patients at time of presentation with fever.
  5. Zinner SH . Changing epidemiology of infections in patients with neutropenia and cancer: emphasis on gram-positive and resistant bacteria. Clin Infect Dis 1999;29:490-4. Abstract/FREE Full Text ↵ Wisplinghoff H, Seifert H,Wenzel RP, et al . Current trends in the epidemiology of nosocomial bloodstream infections in patients with hematological malignancies and solid neoplasms in hospitals in the United States. Clin Infect Dis 2003;36:1103-10. Abstract/FREE Full Text
  6. Initial management of fever and neutropenia. *Limited data to support recommendation. ANC, absolute neutrophil count; CT, computed tomography; MRI, magnetic resonance imaging.
  7. Reassess after 2-4 days of empirical antibiotic therapy. ANC, absolute neutrophil count; CT, computed tomography; IV, intravenous; MRI, magnetic resonance imaging.
  8. High-risk patient with fever after 4 days of empirical antibiotics. C. difficile, Clostridium difficile; IV, intravenous.
  9. J antimicrob chemother 2011 66(2):251-259. Metaanalisis
  10. Administration of granulocyte colony–stimulating proteins based on identified risk factors including older age, bone marrow involvement, radiation to marrow-producing sites (pelvis, sternum, ribs, calvarium, femurs), splenectomy or splenic irradiation in patients with extramedullary hematopoiesis, and Copyright © 2010 Clinical Care Options, LLC. All rights reserved. 16 chemotherapeutic regimens known to induce myelosuppression has reduced the incidence of hospitalizations for febrile neutropenia. To be effective, however, the administration of growth factors requires patient and caregiver education regarding reportable signs and symptoms, a clear plan for discussion of laboratory values and symptoms, and implementation of a practicespecific plan for identification of patients at high risk and prevention strategies for those patients. Maintaining Adherence to Novel Oral Agents