The Prevention and Management of Neutropenic Sepsis In Cancer Patients

The Prevention and Management of Neutropenic Sepsis In Cancer Patients

[Date of Submission]

The Prevention and Management of Neutropenic Sepsis In Cancer Patients

Introduction

There have been huge advancements in the field of the cancer treatment in the last ten years. Plans like NHS Cancer Plans assist these treatments by lending the cancer services funding and structure. One of the treatments of cancer is Chemotherapy. There has been exponential increase in chemotherapy use in order to treat a vast range of tumors (Yarbo, Frogge & Goodman, 2005). It is a well known fact that the number of cancers that used to be resistant to chemotherapy are rapidly thinning out thanks to the development of effective and new drug therapies. Overtime, the treatments of chemotherapy aimed at the advanced metastatic cancer are improving as well and also have a wider variety of drugs for treatment purposes.

Cytostatic chemotherapy used in the treatment of solid tumors, including breast cancer, lung cancer and other malignancies, can cause neutropenia varying depth and duration. When standard chemotherapy regimen reaches the III IV degree of neutropenia, it ranges from 5 to 79%, and on average, 30 40% in different data.

Increased risk of infection in the selection of neutropenia causes symptoms of febrile neutropenia (FN); it requires the use of therapeutic and diagnostic measures and careful attention to the patient due to increased incidence of life threatening complications and even death. Microbiologically documented infections during neutropenia observed in 8 32% of patients with bacteremia, 12 26% of patients, and fever, which is often the only sign of infection in 29 50% of the patients (Zitella, Friese & Hauser, 2006, pp. 739-750).

Febrile neutropenia is a major factor limiting the planned intensive cancer chemotherapy, and usually requires a delay of the next course of treatment or dose reduction of cytostatics, which affects the efficiency of anticancer. As a result, the 20 year follow up of patients treated with accompanying chemotherapy with cyclophosphamide, methotrexate, 5 fluorouracil (CMF). Early breast cancer, showed that patients who received more than 85% of the planned dose intensity of chemotherapy had better disease free survival (42% vs. 26%) and overall survival (40% versus 21%). A applied with adjuvant anthracycline containing chemotherapy regimens reduce the annual death rate from breast cancer in women younger than 50 years is 38% and in women older than 50 years by 20% (Robb, Jarman, Suntharalingam, Higgens, Tennant & Elcock, 2010).

The majority of patients with febrile neutropenia requiring hospitalization for immediate clinical evaluation and use of empirical therapy broad spectrum antibiotics to reduce the mortality associated with delayed treatment of serious infections that occurred against the background of neutropenia.

The main risk factors for infection include the depth and duration of neutropenia. The latter, together with other factors, can be attributed to patients at high or low risk of infection, in accordance with the scale of MASCC, which up forecast of 91%, a specificity of 68% and a sensitivity of 71% for identifying patients at low risk of infection ...