Spectrum and treatment of bacterial infections in cancer patients with granulocytopenia

Details

Serval ID
serval:BIB_A34BEF65EF8D
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Spectrum and treatment of bacterial infections in cancer patients with granulocytopenia
Journal
Recent Results in Cancer Research
Author(s)
Calandra  T.
ISSN
0080-0015 (Print)
Publication state
Published
Issued date
1991
Volume
121
Pages
329-36
Notes
Journal Article Review
Abstract
Bacterial infections remain a frequent cause of morbidity and mortality in cancer patients with granulocytopenia. In recent years the proportion of patients with gram-positive infections, caused mainly by coagulase-negative staphylococci and viridans streptococci, has increased markedly in many institutions. The precise reasons for this recent change in the epidemiology of infection in cancer patients are as yet not fully ascertained. Although less prevalent, gram-negative infections are still the major threat, since they are associated with higher mortality. What constitutes the optimal empirical antibiotic therapy remains a controversial issue. One should however recognize that the results of one particular study may not be relevant to other institutions where the predominant pathogens and the pattern of antibiotic resistance may be different. In addition, the results of studies using various antibiotic regimens should be compared with caution. However, with these limitations in mind, the results of the most recently published studies support the following recommendations: in patients with nonmicrobiologically documented infections, monotherapy with a third-generation cephalosporin or a carbapenem is a safe alternative to combination therapy. For gram-negative bacteremia, combined therapy with an extended-spectrum beta-lactam antibiotic and an aminoglycoside appears preferable. For gram-positive infections, a specific anti-gram-positive antibiotic is not needed in every patient and can safely be added upon identification of the pathogen in those patients not responding to empirical therapy.
Keywords
Agranulocytosis/*complications Anti-Bacterial Agents/therapeutic use Antineoplastic Agents/adverse effects Bacterial Infections/*drug therapy/etiology/microbiology Humans Neoplasms/*complications/drug therapy
Pubmed
Web of science
Create date
25/01/2008 13:28
Last modification date
20/08/2019 15:09
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