EurekaMag
+ Translate
+ Most Popular
Cunninghamia lanceolata plantations in China
Mammalian lairs in paleo ecological studies and palynology
Studies on technological possibilities in utilization of anhydrous milk fat for production of recombined butter-like products
Should right-sided fibroelastomas be operated upon?
Large esophageal lipoma
Apoptosis in the mammalian thymus during normal histogenesis and under various in vitro and in vivo experimental conditions
Poissons characoides nouveaux ou non signales de l'Ilha do Bananal, Bresil
Desensitizing efficacy of Colgate Sensitive Maximum Strength and Fresh Mint Sensodyne dentifrices
Administration of fluid by subcutaneous infusion: revival of a forgotten method
Tundra mosquito control - an impossible dream?
Schizophrenia for primary care providers: how to contribute to the care of a vulnerable patient population
Geochemical pattern analysis; method of describing the Southeastern limestone regional aquifer system
Incidence of low birth weights in a hospital of Mexico City
Tabanidae
Graded management intensity of grassland systems for enhancing floristic diversity
Microbiology and biochemistry of cheese and fermented milk
The ember tetra: a new pygmy characid tetra from the Rio das Mortes, Brazil, Hyphessobrycon amandae sp. n. (Pisces, Characoidei)
Risk factors of contrast-induced nephropathy in patients after coronary artery intervention
Renovation of onsite domestic wastewater in a poorly drained soil
Observations of the propagation velocity and formation mechanism of burst fractures caused by gunshot
Systolic blood pressure in a population of infants in the first year of life: the Brompton study
Haematological studies in rats fed with metanil yellow
Studies on pasteurellosis. I. A new species of Pasteurella encountered in chronic fowl cholera
Dormancy breaking and germination of Acacia salicina Lindl. seeds
therapy of lupus nephritis. a two-year prospective study

Empiric therapy for the febrile neutropenic patient. Design bias


Empiric therapy for the febrile neutropenic patient. Design bias



Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer 6(5): 449-456



ISSN/ISBN: 0941-4355

PMID: 9773462

DOI: 10.1007/s005200050193

Empiric therapy is practical and must be begun promptly; the specific regimen chosen must be based upon local conditions and epidemiology. It must be recalled that subgroups of patients are not necessarily equivalent to the majority, i.e., there are low-risk patients for whom ambulatory and/or oral therapy is appropriate and, conversely, there are high-risk patients who have a potential for a high mortality and who, while perhaps few in number, are of critical importance. Further, many of these patients are very complex, and this leads to a high level of physician concern and insecurity. This physician concern, in turn, leads to a tendency to modify regimens, given that the physician all too often is dealing with inadequate diagnostic information owing to the patient situation. The physician's choice of modification is highly dependent upon knowledge of the regimen the patient is already receiving. There is a need for clear definition of endpoints, and these must be established before the study is initiated. All too many published studies are too small to evaluate the endpoint that has been defined, and many others, although sufficient in size, have all of the problems inherent in studies conducted at multiple sites by multiple individuals with differing degrees of commitment or enthusiasm toward the study at hand. A few implications for study design and evaluation seem evident: it is critical to define endpoints and execute the study accordingly. This means determining the size of the population needed and determining the presence or absence of risk groups. Patients to be excluded e.g., those in whom infection is doubted must be selected on the basis of objective data by an observer blinded to both the outcome and the treatment. Similarly, the classification of response should preferably be done by an observer not influenced by knowledge of the therapy being given. Finally, and similarly, the decision to modify therapy (especially if modification is equivalent to defining failure with the regimen) should not be influenced by knowledge of the therapy being administered.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 045950667

Download citation: RISBibTeXText

Related references

Empiric therapy for the febrile neutropenic patient: Design bias. Consensus Meeting of the Mascc Study Section Infectious Diseases (Brussels 1997-12) 6(5): 449-456, 1998

Overview of empiric antibiotic therapy for the febrile neutropenic patient. Reviews of Infectious Diseases 7(Suppl 4): S734-S740, 1985

Simplification of empiric therapy for the febrile, neutropenic oncology patient. Recent Results in Cancer Research. Fortschritte der Krebsforschung. Progres Dans les Recherches sur le Cancer 132: 67-77, 1993

Therapy of choice for the empiric treatment of the febrile neutropenic patient. Drug Intelligence and Clinical Pharmacy 20(10): 767-769, 1986

Preservation of colonization resistance parameters during empiric therapy with aztreonam in the febrile neutropenic patient. Reviews of Infectious Diseases 7(Suppl 4): S747-S761, 1985

Cost comparison of seven antibiotic combinations as empiric therapy in a simulated febrile neutropenic patient. American Journal of Hospital Pharmacy 42(11): 2484-2488, 1985

Cost comparison of seven antibiotic combinations as empiric therapy in a simulated febrile neutropenic patient. American Journal of Health-System Pharmacy 42(11): 2484-2488, 1985

Empiric use of vancomycin in the febrile neutropenic patient. Journal of Infectious Diseases 165(3): 591, 1992

Antibiotic combinations for the empiric treatment of the febrile neutropenic patient. Schweizerische Medizinische Wochenschrift. Supplementum 14: 58-63, 1983

Empiric treatment of localized infections in the febrile neutropenic patient with monotherapy. Leukemia and Lymphoma 9(3): 193-203, 1993

Empiric therapy in the management of febrile neutropenic cancer patients. Current Therapeutic Research 53(1): 23-28, 1993

Empiric therapy for infections in the febrile, neutropenic, compromised host. Medical Clinics of North America 79(3): 559-580, 1995

Using teicoplanin for empiric therapy of febrile neutropenic patients with haematological malignancies. British Journal of Haematology 76(Suppl 2): 45-48, 1990

Non-nephrotic empiric antimicrobial therapy in febrile neutropenic cancer patients. European Journal of Cancer (1990) 28A (4-5): 867-870, 1992

Empiric therapy with aztreonam for febrile neutropenic patients with hematological malignancies. Kansenshogaku Zasshi. Journal of the Japanese Association for Infectious Diseases 63(9): 1022-1025, 1989