TY - JOUR
T1 - Antimicrobial prophylaxis for adult patients with cancer-related immunosuppression
T2 - ASCO and IDSA clinical practice guideline update
AU - Taplitz, Randy A.
AU - Kennedy, Erin B.
AU - Bow, Eric J.
AU - Crews, Jennie
AU - Gleason, Charise
AU - Langston, Amelia A.
AU - Flowers, Christopher R.
AU - Hawley, Douglas K.
AU - Nastoupil, Loretta J.
AU - Rolston, Kenneth V.
AU - Rajotte, Michelle
AU - Strasfeld, Lynne
N1 - Publisher Copyright:
© 2018 by American Society of Clinical Oncology.
PY - 2018/10/20
Y1 - 2018/10/20
N2 - To provide an updated joint ASCO/Infectious Diseases Society of America (IDSA) guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with cancer and its treatment. Methods ASCO and IDSA convened an update Expert Panel and conducted a systematic review of relevant studies from May 2011 to November 2016. The guideline recommendations were based on the review of evidence by the Expert Panel. Results Six new or updated meta-analyses and six new primary studies were added to the updated systematic review. Recommendations Antibacterial and antifungal prophylaxis is recommended for patients who are at high risk of infection, including patients who are expected to have profound, protracted neutropenia, which is defined as <100 neutrophils/μL for > 7 days or other risk factors. Herpes simplex virus- seropositive patients undergoing allogeneic hematopoietic stem-cell transplantation or leukemia induction therapy should receive nucleoside analog-based antiviral prophylaxis, such as acyclovir. Pneumocystis jirovecii prophylaxis is recommended for patients receiving chemotherapy regimens that are associated with a > 3.5% risk for pneumonia as a result of this organism (eg, those with ≥ 20 mg prednisone equivalents daily for ≥ 1 month or on the basis of purine analog usage). Treatment with a nucleoside reverse transcription inhibitor (eg, entecavir or tenofovir) is recommended for patients at high risk of hepatitis B virus reactivation. Recommendations for vaccination and avoidance of prolonged contact with environments that have high concentrations of airborne fungal spores are also provided within the updated guideline.
AB - To provide an updated joint ASCO/Infectious Diseases Society of America (IDSA) guideline on antimicrobial prophylaxis for adult patients with immunosuppression associated with cancer and its treatment. Methods ASCO and IDSA convened an update Expert Panel and conducted a systematic review of relevant studies from May 2011 to November 2016. The guideline recommendations were based on the review of evidence by the Expert Panel. Results Six new or updated meta-analyses and six new primary studies were added to the updated systematic review. Recommendations Antibacterial and antifungal prophylaxis is recommended for patients who are at high risk of infection, including patients who are expected to have profound, protracted neutropenia, which is defined as <100 neutrophils/μL for > 7 days or other risk factors. Herpes simplex virus- seropositive patients undergoing allogeneic hematopoietic stem-cell transplantation or leukemia induction therapy should receive nucleoside analog-based antiviral prophylaxis, such as acyclovir. Pneumocystis jirovecii prophylaxis is recommended for patients receiving chemotherapy regimens that are associated with a > 3.5% risk for pneumonia as a result of this organism (eg, those with ≥ 20 mg prednisone equivalents daily for ≥ 1 month or on the basis of purine analog usage). Treatment with a nucleoside reverse transcription inhibitor (eg, entecavir or tenofovir) is recommended for patients at high risk of hepatitis B virus reactivation. Recommendations for vaccination and avoidance of prolonged contact with environments that have high concentrations of airborne fungal spores are also provided within the updated guideline.
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U2 - 10.1200/JCO.18.00374
DO - 10.1200/JCO.18.00374
M3 - Article
C2 - 30179565
AN - SCOPUS:85055052046
SN - 0732-183X
VL - 36
SP - 3043
EP - 3054
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 30
ER -