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Leuk Lymphoma. 2012 Jan;53(1):8-18. doi: 10.3109/10428194.2011.602770. Epub 2011 Aug 24.

Management of gram-positive bacterial infections in patients with cancer.

Author information

1
Division of Infectious Diseases, Wayne State University, Detroit, MI, USA.

Abstract

Bacterial infections, particularly those due to gram-positive bacteria, continue to predominate in patients with cancer. Coagulase-negative and coagulase-positive staphylococci and enterococci remain as common pathogenic microorganisms. Clostridium difficile has emerged as a significant pathogen. Major clinical syndromes include vascular catheter-related infection, febrile neutropenia, diarrhea and colitis. Rising antimicrobial resistance among gram-positive bacteria is of serious concern. The clinical utility of penicillin against streptococci and vancomycin against coagulase-negative and coagulase-positive staphylococci and enterococci may be rapidly diminishing. Liberal empiric use of vancomycin during neutropenic fever needs careful reconsideration. Newer promising anti-gram-positive bacterial drugs with activity against methicillin-resistant staphylococci include daptomycin, linezolid, tigecycline and telavancin. However, toxicity concerns, limited data in immunocompromised populations and high cost prevent the widespread use of these drugs among patients with cancer.

PMID:
21740298
DOI:
10.3109/10428194.2011.602770
[Indexed for MEDLINE]

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