ABSTRACT
Over the past three decades, considerable changes have occurred in the distribution of bacteria causing infection in febrile neutropenic patients with cancer. When the concept of empirical therapy for fever in these patients was introduced, bacteremia occurred in about 20% of febrile neutropenic episodes, and approximately 70% of these bloodstream infections were caused by gram-negative bacteria (predominantly Escherichia coli, Klebsiella sp., and Pseudomonas aeruginosa) and Staphylococcus aureus. The distribution of these organisms was so predictable that empirical therapy for febrile neutropenic patients directed against these organisms as introduced by Schimpff et al., readily became the accepted standard of care (1).
