Prevention and Treatment of Cancer-Related Infections

Baden, Lindsey R.; Bensinger, William I.; Angarone, Michael; Casper, Corey; Dubberke, Erik R.; Freifeld, Alison G.; Garzon, Ramiro; Greene, John N.; Greer, John P.; Ito, James I.; Karp, Judith E.; Kaul, Daniel; King, E. J.; Mackler, Emily; Marr, Kieren A.; Montoya, José G.; Morris-Engemann, Ashley; Pappas, Peter G.; Rolston, Kenneth; Segal, Brahm H.; Seo, Susan K.; Swaminathan, Sankar; Naganuma, Maoko; Shead, Dorothy A.

doi:10.6004/jnccn.2012.0146

Cited by 185 publications

(160 citation statements)

References 479 publications

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“…5,8,[97][98][99] On the contrary, the Australian Consensus Guidelines recommend to consider the use of prophylaxis only for outpatients receiving HSCT and in palliative care patients with bone marrow failure. 18 All these recommendations are based on the results of 2 large randomized, double-blinded and placebo-controlled trials, published in 2005, which assessed the efficacy of levofloxacin during neutropenia in patients undergoing chemotherapy for solid cancers or acute leukemia.…”

Section: Othersmentioning

confidence: 99%

“…and VRE. 5 The CVC removal is also advisable in case of hemodynamic instability, tunnel or port pocket infections, endocarditis, septic thrombosis and if blood cultures are still positive after 72 hours of appropriate therapy. 8 The length of antibiotic treatment in neutropenic patients is another issue that has been recently readdressed.…”

Section: Other Aspects Of Management Of Bsis In Neutropeniamentioning

confidence: 99%

“…[2][3][4] Definitions of BSIs, sepsis, neutropenia and fever are reported in Table 1. [5][6][7][8] In the last decade, a worldwide increase in multidrug resistant (MDR) strains has occurred and numerous initiatives have tried to draw public attention to the fact that there are bacteria against which few or no active antibiotics exist. [9][10][11] The acronym ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.)…”

Section: Introductionmentioning

confidence: 99%

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Bloodstream infections in neutropenic cancer patients: A practical update

2016

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Bloodstream infections (BSI) are among the most frequent complications in neutropenic cancer patients and, if caused by Gram-negative rods, are associated with high mortality. Thus, fever during neutropenia warrants prompt empirical antibiotic therapy which should be active against the most frequent Gram-negatives. In the last decade, there has been a worldwide increase in multidrug resistant (MDR) strains. In these cases, the traditional choices such as oral therapy, ceftazidime, cefepime, piperacillin-tazobactam, or even carbapenems, might be ineffective. Therefore novel deescalation approach has been proposed for patients who are at high risk for infections due to MDR bacteria. It consists of starting antibiotics which cover the most probable resistant strain but it is narrowed down after 72 hours if no MDR pathogen is isolated. With increasing bacterial resistance, the benefit of fluoroquinolone prophylaxis during prolonged neutropenia remains to be confirmed. Antibiotic stewardship and infection control programs are mandatory in every cancer center.

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Section: Othersmentioning

confidence: 99%

Section: Other Aspects Of Management Of Bsis In Neutropeniamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bloodstream infections in neutropenic cancer patients: A practical update

2016

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“…25 The use of antibacterial prophylaxis during periods of prolonged neutropenia in adult patients with acute leukemia is supported by data from a meta-analysis showing its use to be associated with decreased risk of death, 83 and is recommended in adult supportive care guidelines from both the National Comprehensive Cancer Network and the American Society of Clinical Oncology. 84,85 Data on the use of antibacterial prophylaxis in children are extremely limited. Studies evaluating the utility of levofloxacin prophylaxis during ALL induction and in those being treated with intensive therapy for relapsed disease are being done through the Dana-Farber Cancer Institute consortium and COG, respectively.…”

Section: Treatment For High-risk Allmentioning

confidence: 99%

Clinically defining and managing high-risk pediatric patients with acute lymphoblastic leukemia

Alexander

2014

Hematology

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For children with acute lymphoblastic leukemia, the identification of those at higher risk of disease recurrence and modifying therapy based on this risk is a critical component to the provision of optimal care. The specific definitions of high-risk ALL vary across cooperative groups, but the themes are consistent, being largely based on leukemia biology and disease response. Intensification of conventional chemotherapy for those with high-risk disease has led to improved outcomes. It is anticipated that the development of rational targeted therapy for specific biologically unique subsets of children with leukemia will contribute to ongoing progress in improving the outcomes for children with acute lymphoblastic anemia. Learning Objectives• To understand current criteria used to identify children with high-risk ALL • To understand therapeutic strategies for children with highrisk ALL

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“…Although neutropenia remains a key risk factor for development of infection, non-neutropenic immunocompromised states pose a similar infection risk. 1 Patients at highest risk for serious infections are those with profound, prolonged neutropenia (< 100 cells/µL for more than 7 days), such as those undergoing induction chemotherapy for acute leukemia and those undergoing allogeneic stem cell transplant, as well as non-neutropenic patients receiving intensive immunosuppressive treatment for graftversus-host disease.…”

mentioning

confidence: 99%

Evaluation of a Once-Daily Vancomycin Regimen in an Outpatient Leukemia/Bone Marrow Transplant Clinic (OD-VANCO Study)

Luo

Hussaini

Lacaria

et al. 2014

CJHP

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Background:The Leukemia/Bone Marrow Transplant Program of British Columbia manages patients with high-risk febrile neutropenia and those with non-neutropenic immunocompromised states in an outpatient clinic setting. Because the program treats outpatients only, once-daily administration of IV antibiotics is desirable. A high-dose, once-daily vancomycin nomogram was developed and implemented as part of the antibiotic treatment regimen.

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Prevention and Treatment of Cancer-Related Infections

Cited by 185 publications

References 479 publications

Bloodstream infections in neutropenic cancer patients: A practical update

Bloodstream infections in neutropenic cancer patients: A practical update

Clinically defining and managing high-risk pediatric patients with acute lymphoblastic leukemia

Evaluation of a Once-Daily Vancomycin Regimen in an Outpatient Leukemia/Bone Marrow Transplant Clinic (OD-VANCO Study)

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