Antimicrobial prophylaxis for adult patients with cancer-related immunosuppression: ASCO and IDSA clinical practice guideline update

Randy A. Taplitz, Erin B. Kennedy, Eric J. Bow, Jennie Crews, Charise Gleason, Amelia A. Langston, Christopher R. Flowers, Douglas K. Hawley, Loretta J. Nastoupil, Kenneth V. Rolston, Michelle Rajotte, Lynne Strasfeld

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)3043-3054
Number of pages12
JournalJournal of Clinical Oncology
Volume36
Issue number30
DOIs
StatePublished - Oct 20 2018

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Practice Guidelines
Immunosuppression
Communicable Diseases
Neoplasms
Tenofovir
Guidelines
Nucleosides
Pneumocystis carinii
Fungal Spores
Acyclovir
Hematopoietic Stem Cell Transplantation
Simplexvirus
Prednisone
Neutropenia
Hepatitis B virus
Reverse Transcription
Antiviral Agents
Meta-Analysis
Pneumonia
Leukemia

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Antimicrobial prophylaxis for adult patients with cancer-related immunosuppression : ASCO and IDSA clinical practice guideline update. / Taplitz, Randy A.; Kennedy, Erin B.; Bow, Eric J.; Crews, Jennie; Gleason, Charise; Langston, Amelia A.; Flowers, Christopher R.; Hawley, Douglas K.; Nastoupil, Loretta J.; Rolston, Kenneth V.; Rajotte, Michelle; Strasfeld, Lynne.

In: Journal of Clinical Oncology, Vol. 36, No. 30, 20.10.2018, p. 3043-3054.

Research output: Contribution to journalArticle

Taplitz, RA, Kennedy, EB, Bow, EJ, Crews, J, Gleason, C, Langston, AA, Flowers, CR, Hawley, DK, Nastoupil, LJ, Rolston, KV, Rajotte, M & Strasfeld, L 2018, 'Antimicrobial prophylaxis for adult patients with cancer-related immunosuppression: ASCO and IDSA clinical practice guideline update', Journal of Clinical Oncology, vol. 36, no. 30, pp. 3043-3054. https://doi.org/10.1200/JCO.18.00374
Taplitz, Randy A. ; Kennedy, Erin B. ; Bow, Eric J. ; Crews, Jennie ; Gleason, Charise ; Langston, Amelia A. ; Flowers, Christopher R. ; Hawley, Douglas K. ; Nastoupil, Loretta J. ; Rolston, Kenneth V. ; Rajotte, Michelle ; Strasfeld, Lynne. / Antimicrobial prophylaxis for adult patients with cancer-related immunosuppression : ASCO and IDSA clinical practice guideline update. In: Journal of Clinical Oncology. 2018 ; Vol. 36, No. 30. pp. 3043-3054.
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