The principles of antibiotic therapy for febrile neutropenia are as follows: 1. Immediately initiate antibiotic therapy after diagnosis; 2. The choice of the first drug is carried out empirically, depending on the clinical and epidemiological situation; 3. After microbiological identification of a bacterial infection, anti-bacterial therapy is corrected; 4. The assessment of the correctness of the choice of antibiotic is carried out 3 days after its appointment. The main criterion of efficacy is considered to be the positive dynamics of fever and intoxication. Otherwise, the antibiotic is replaced in accordance with the results of bacteriological examination of sputum or reserve drugs are used; 5. For light or moderate pneumonia, the use of a single antibiotic is possible.In order to adequately cover all potential pathogens in patients with febrile neutropenia, it is advisable to prescribe empiric therapy, which may consist of monotherapy with broad-spectrum antibiotics (III-IV cephalosporins, carbapenema) or a combination of two-three antibiotics. It is obligatory to use drugs directed against dangerous gram-negative pathogens (Pus synergis) due to the severity and severity of infectious complications caused by these pathogens; 6. The duration of antibiotic therapy is 7 to 10 days. In patients with severe hospital pneumonia, its duration is extended to 2–3, and sometimescarbapenems) or from a combination of two – three antibiotics. It is obligatory to use drugs directed against dangerous gram-negative pathogens (Pus synergis) due to the severity and severity of infectious complications caused by these pathogens; 6. The duration of antibiotic therapy is 7 to 10 days. In patients with severe hospital pneumonia, its duration is extended to 2–3, and sometimescarbapenems) or from a combination of two – three antibiotics. It is obligatory to use drugs directed against dangerous gram-negative pathogens (Pus synergis) due to the severity and severity of infectious complications caused by these pathogens; 6. The duration of antibiotic therapy is 7 to 10 days. In patients with severe hospital pneumonia, its duration is extended to 2–3, and sometimes and more weeks .

The main etiological factor in the onset of pneumonia is pneumococcus, macrolides (dirithromycin, roxithromycin, clarithromycin, spiramycin, midecamycin, azithromycin) and penicillins serve as the drugs of choice in these situations. Cephalosporins of the II – IV generations and fluoroquinolones active against gram-positive and gram-negative microorganisms have been widely used. In severe cases of infectious complications, aminoglycosides of the second and third generations are used, but nephrotoxicity must be taken into account. Carbapenems are reserve drugs and are used for severe pneumonia and other infectious complications, which arise mainly against the background of developed deep cytostatic myelodepression. Pneumonia in neutropenia, granulocytopenia is often caused by gram-negative flora (E. Coli, P. aeruginosae).In this case, the drugs of choice are cephalosporins of the third generation in combination with aminoglycosides, as well as with co-trimoxazole ohm (septrin, biseptol) . Co-trimoxazole is active against Enterobacteriaceae and staphylococci, but P. aeruginosae and E. Faec alis are resistant to it . In case of pneumonia caused by S. aureus strains, it is advisable to assign a glycopeptide s (vancomycin, tekoplanin) . When it is not possible to use glycopeptide antibiotics, phosphomycin and amyoglycosides are used in high doses . For vancomycin-resistant enterococcal infections, it is more effective than nIvox (lineolide) .