CHAPTER 46. Antibacterial, Antifungal and Antiviral Prophylaxis in High-Risk Cancer and Stem Cell Transplant Population by Marcio Nucci and John R. Wingard

ABSTRACT

Infection represents a major cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) recipients and cancer patients. Antimicrobial prophylaxis is justifiable in these immunosuppressed patients, but its benefits may be offset by potential problems such as the selection for resistant organisms, an increase in toxicity and cost. Therefore, any attempt to administer an antimicrobial agent should be accompanied by a reflection of the potential benefits and risks of prophylaxis. This chapter reviews the rationale and current recommendations for antimicrobial prophylaxis of infections in HSCT recipients and in high-risk cancer patients, the later group represented mostly by patients with hematologic malignancies, including those with acute leukemia, multiple myeloma and lymphoma.