Prevention and treatment of cancer-related infections

Brahm H. Segal, Alison G. Freifeld, Lindsey Robert Baden, Arthur E. Brown, Corey Casper, Erik Dubberke, Michael Gelfand, John N. Greene, Michael G. Ison, James I. Ito, Judith E. Karp, Daniel R. Kaul, Earl King, Emily Mackler, Guido Marcucci, Jose G. Montoya, Ashley Morris Engemann, Ken Rolston, Angelina S. The

Research output: Contribution to journalReview article

103 Scopus citations

Abstract

Previous NCCN guidelines related to infectious complications of cancer were primarily focused on fever and neutropenia. However, the guidelines were revised in 2007 to address prevention and treatment of infections in neutropenic and non-neutropenic immunocompromised patients with cancer. These NCCN guidelines on "Prevention and Treatment of Cancer-Related Infections" replace the previous guidelines on "Fever and Neutropenia." Substantial progress has been made in preventing and treating infectious complications of neutropenia and immunosuppressive therapy in patients with cancer. It is essential to know the patient's quantitative and qualitative immune defects and to stratify the risk for specific pathogens in the context of the history, physical examination, radiologic, and laboratory data. The development of antipseudomonal β-lactam agents and the routine use of empiric antibacterial therapy at the onset of neutropenic fever reduced mortality from bacterial infections.302 More patients were treated with potent cytotoxic regimens (e.g., for acute leukemia) and received allogeneic stem cell transplants; opportunistic viral and fungal infections became an important cause of mortality in these patients. In addition, the increasing prevalence of antibiotic-resistant pathogens has challenged the clinician to use antimicrobial therapy wisely. Infection control should not rely exclusively on antimicrobial prophylaxis, but rather should continue to incorporate standard infection control measures and demand careful hand-washing by all health care professionals who come into contact with immunocompromised patients.

Original languageEnglish (US)
Pages (from-to)122-174
Number of pages53
JournalJNCCN Journal of the National Comprehensive Cancer Network
Volume6
Issue number2
StatePublished - Mar 11 2008

Keywords

  • Absolute neutrophil count
  • Antibiotic-resistant organisms
  • Antifungal agents
  • Antimicrobial
  • Antiviral agents
  • Cancer therapy
  • Fever
  • Guidelines
  • Infection
  • NCCN Clinical Practice Guidelines
  • Neutropenia
  • Stem cell transplant

ASJC Scopus subject areas

  • Oncology

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  • Cite this

    Segal, B. H., Freifeld, A. G., Baden, L. R., Brown, A. E., Casper, C., Dubberke, E., Gelfand, M., Greene, J. N., Ison, M. G., Ito, J. I., Karp, J. E., Kaul, D. R., King, E., Mackler, E., Marcucci, G., Montoya, J. G., Engemann, A. M., Rolston, K., & The, A. S. (2008). Prevention and treatment of cancer-related infections. JNCCN Journal of the National Comprehensive Cancer Network, 6(2), 122-174.