Clinical and economic considerations of empirical antibacterial therapy of febrile neutropenia in cancer.

Febrile neutropenia is a condition that can develop in patients with cancer following the administration of myelosuppressive chemotherapy or radiation therapy. The current standard of patient management involves the empirical use of a combination of antibacterials or a single broad spectrum agent to offer extensive antibacterial coverage of both Gram-positive and Gram-negative micro-organisms. Over the past 25 years, febrile neutropenia has changed from a condition that was fatal in over 50% of patients to a condition with an infection-related mortality rate of less than 10%. A major reason behind these extraordinary advances in patient care has been the many well-designed randomised trials of empirical antibacterial therapy that have been conducted over this period of time. In contrast to this finding, a review of the literature revealed limited economic data on the empirical treatment of febrile neutropenia in patients with cancer. Therefore, there is a definite need to conduct more pharmacoeconomic research in this area and to develop methods of implementing the findings of such studies.