Vol.68 No.1 January 2020
Infection control practices in cancer patients undergoing chemotherapy
Division of General Internal Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, Japan
Abstract
Patients with cancer are at an enhanced risk for infections due to the underlying disease and its treatment; however, preventive infection-control measures can reduce the risk of such complications. It is imperative to understand the possible causes of infectious complications and the predisposing factors involved in order to offer more effective infection-control measures. A clear understanding of the specific components of immune deficiency, such as neutropenia, cellular or humoral immunity defects, and skin or mucosal barrier injuries enables easy prediction of the risk of infectious diseases.
Several guidelines recommend the use of prophylactic antimicrobials for selected patients who are immunocompromised. For example, fluoroquinolone prophylaxis is recommended for high-risk patients with prolonged and profound neutropenia. However, drug resistance has increased in recent years, potentially decreasing the effectiveness of prophylactic antibiotics. Therefore, considering up-to-date information on prophylaxis efficacy and local antibiograms is mandatory for ensuring appropriate prescription of prophylactic antimicrobials.
There are many infection-control measures for which sufficient evidence of efficacy does not yet exist, such as provision of a protective environment, neutropenic diets, and antibiotic prophylaxis. It is necessary to provide infection-control measures in a flexible manner based on current evidence, with continuous evaluation of the available evidence.
Received
October 15, 2018
Accepted
November 5, 2019
Jpn. J. Chemother. 68 (1): 132-142, 2020
