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La presente revisión pretende ofrecer una visión de conjunto de los cambios que se han ido produciendo durante los últimos 40 años en los agentes etiológicos aislados en los pacientes neutropénicos con fiebre, así como en sus patrones de sensibilidad a los antibacterianos y su implicación en las pautas de tratamiento empírico. Esta visión global permite observar cómo los cambios introducidos en el tratamiento de estos pacientes se han acompañado, de forma indefectible, de cambios en los microorganismos causales, que a su vez han obligando a rediseñar las pautas terapéuticas. Estos constantes cambios, así como los notables avances alcanzados en las técnicas diagnósticas y en el reconocimiento de subpoblaciones de pacientes con distintos grados de morbimortalidad, obligan a los diversos especialistas implicados en el manejo de los pacientes neutropénicos con fiebre a una constate actualización de sus conocimientos.
Palabras clave:
Neutropenia febril
Cáncer
Infección
Paciente inmunodeprimido
The present review aims to provide an overall view of the changes that have occurred in the last 40 years in the etiological agents isolated in febrile neutropenic patients, as well as in their antibacterial susceptibility patterns and their involvement in empirical treatment regimes. This overall view allows us to observe how the modifications introduced in the treatment of these patients has been accompanied by continual changes in the causative microorganisms, which in turn has required treatment regimens to be redesigned. Because of these constant changes, the significant advances achieved in diagnostic techniques and the recognition of subpopulations of patients with distinct degrees of morbidity and mortality, specialists in the various fields involved in the management of febrile neutropenic patients must constantly update their knowledge.
Key words:
Febrile neutropenia
Cancer
Infection
Immunodepressed patient
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