Empiric therapy for febrile neutropenia: what are the choices?

The management of febrile neutropenia has evolved gradually over the years toward a risk-adapted strategy based on validated prediction rules by risk of complications. The drug choice for empiric therapy is influenced by several factors, either related to the patient or to the institution. Microbiological distribution of offending pathogens and their pattern of susceptibility to antibiotics are continuously changing. New mechanisms of resistance in both Gram-negative and -positive bacteria have emerged. Guidelines and general statements should always be considered with the local epidemiology.