Neutropenic Sepsis: Antibiotic Prophylaxis

Neutrophils play a vital role in the immune response to all infections ranging from fungal to viral to bacterial. Hematologic malignancies and the treatment plans for these malignancies are common causes of neutropenia. Neutropenic hosts are uniquely vulnerable to several rare and severe infections that come with high morbidity and mortality. Management of the neutropenic host is a complicated process that requires consideration of all possible infectious processes. Treatment spans a wide course from prophylactic treatments to treatment of active infections. The awareness and prompt response to evidence of infection is vital in the management of neutropenia. Specific attention to fevers can be helpful in identifying infection in neutropenic patients who do not mount infectious responses in the same way as immunocompetent patients. Investigation of fevers and identification of the cause of a fever require consideration of rare microbes that do not commonly cause infection in immunocompetent hosts. Neutropenic hosts require more extensive infectious evaluation and broader empiric treatment than what would be considered in an immunocompetent host. Ultimately the prophylaxis of infection, monitoring for signs of infection, diagnosis of cause of infection, and treatment of infection in the neutropenic host is an important and complex process integral to the management of hematologic malignancy.