Final answer:
In cases of cellulitis with accompanying neutropenia, broad-spectrum or combination antibiotic therapy rather than monotherapy is typically recommended due to the high risk for opportunistic infections and the need to cover a wide range of potential pathogens in such immunocompromised patients.
Step-by-step explanation:
When dealing with a patient who is neutropenic and has a severe infection like cellulitis, it is usually recommended to initiate broad-spectrum antibiotic coverage rather than monotherapy. This approach covers a wide range of potential pathogens, given the compromised state of the patient's immune system due to the low neutrophil count. Critical thinking is required in such cases because neutropenic patients are at high risk for opportunistic infections and may not respond to standard treatments as a non-neutropenic patient would. However, treatment also needs to be personalized based on blood culture results, the patient's overall health status, and potential antibiotic susceptibilities. As demonstrated by various clinical case studies, when initial treatments fail, reassessment and adjustment of antimicrobial therapy are necessary, which may include multi-drug regimens, especially if the infection persists or is caused by drug-resistant bacteria.
In cases of cellulitis with accompanying neutropenia, using a combination of antibiotics (polytherapy) might increase the likelihood of treating all potentially responsible bacteria. Only after identifying the specific pathogens and their antibiotic sensitivities can the physician consider narrowing down the treatment to monotherapy. Until then, broad-spectrum or combination antibiotic therapy remains the standard of care for neutropenic patients with serious infections.