This podcast episode explores the challenges and considerations in managing infections in hematological and neutropenic patients. It highlights the high frequency of infection, particularly bloodstream infections, and the presence of multidrug-resistant (MDR) pathogens. Neutropenic fever, its causes, and the risk factors associated with it are discussed. The episode emphasizes the importance of prompt empirical treatment, hospitalization, and intravenous antibiotics for high-risk febrile neutropenia patients. The use of fluoroquinolone prophylaxis and its potential risks are also examined. The section emphasizes the importance of antibiotic management in septic shock and the need for an escalation strategy for empirical antibiotics. The benefits of combining beta-lactams with aminoglycosides in reducing mortality and the reassessment of antibiotics in neutropenic patients are highlighted. Two studies published in 2022 and 2023 demonstrate that short-course antibiotics do not increase mortality in neutropenic patients. The episode concludes by emphasizing the overall high mortality rate in hematological and transplant patients and the importance of broad-spectrum antibiotics, appropriate empirical antibiotic selection, and considering short-course antibiotics.
