ASCO GUIDELINES Bundle

Fever and Neutropenia (ASCO)

ASCO GUIDELINES App Bundle brought to you fcourtesy of Guideline Central. All of these titles are available for purchase on our website, GuidelineCentral.com. Enjoy!

Issue link: https://eguideline.guidelinecentral.com/i/284307

Contents of this Issue

Navigation

Page 4 of 11

Viruses Î Lamivudine is recommended for prophylaxis in patients at substantial risk for reactivation of hepatitis B infection. Î Use a nucleoside analog as prophylaxis to prevent reactivation of infection due to Herpesviruses (Herpes simplex virus or Herpes zoster virus) in seropositive patients being treated for certain hematologic malignancies (see details in the full guideline). Î Seasonal influenza immunization is recommended for all patients receiving chemotherapy for malignancy, and for all family and household contacts. •  Utilize trivalent inactivated vaccine for influenza immunization. •  In select circumstances following proven exposure of a susceptible cancer patient, a neuraminidase inhibitor (eg, oseltamivir, zanamivir) may be offered. Additional Precautions Î All healthcare workers should follow hand hygiene guidelines including: •  Handwashing practices to reduce exposure through contact transmission and •  Respiratory hygiene/cough etiquette guidelines to reduce exposure through droplet transmission. Î Outpatients with neutropenia due to cancer therapy should avoid prolonged contact with environments that have high concentrations of airborne fungal spores (eg, construction and demolition sites). Î None of the following measures is routinely necessary to prevent infection of afebrile outpatients with a malignancy and neutropenia: •  Protected environments (High-Efficiency Particulate Air [HEPA] filters with or without laminar air flow) •  Respiratory or surgical masks (to prevent invasive aspergillosis) •  Footwear exchange at entry and exit •  A "neutropenic diet" or similar nutritional interventions. Note: Gowning and gloving should be considered only in accordance with local Infection Prevention and Control practices for antibiotic-resistant organisms – eg, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, or extended-spectrum ß-lactamase-producing and carbapenemase-producing Gram-negative bacilli. Selecting for Outpatient Therapy Î Medical complications of FN occur in as many as 11% of patients identified as low risk for medical complications in studies validating risk indices or scoring systems. Therefore inpatient treatment is the standard approach for managing an FNE. However, outpatient management may be acceptable for carefully selected patients.

Articles in this issue

Archives of this issue

view archives of ASCO GUIDELINES Bundle - Fever and Neutropenia (ASCO)