Guidelines for Complications of Cancer Treatment Vol VIII Part B

trial design issues.1 Fluconazole should not be used in empiricsetting if it was used in prophylaxis and has limitation due tolack of activity against molds.Pre-emptive antifungal therapy- (level-3)This is a new concept which involves Chest and Sinus CTScan, laboratory markers or both to decide antifungal therapy.For this to be used in clinical practice serology assay needs tobe validated. Evidence is preliminary at present for its routineuse.Follow up of patients with neutropenic fever-Daily evaluation by health care professional is important.Regular review of previously obtained culture should be done.Repeat blood cultures for clearance of blood infections areneeded. Evaluate drug toxicity and end organ toxicity (LFTand renal function test twice a week). Overall response needsto be evaluated between 3-5 days.Follow up therapy of responding patients-It is important to consider if patient has documented infectionor notNeutrophils more thanOr equal to500 cell/mcldiscontinuetherapyFever ofunknown origin378Neutrophils lessthan500cell/mclcontinue tillneutrophil recoveryor discontinue 7-14days of antibiotics orswitch to oralantibiotics tillneutrophils recovers