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01-06-2016 | Clinical Guides in Oncology

Management of infection and febrile neutropenia in patients with solid cancer

Authors: J. A. Virizuela, J. Carratalà, J. M. Aguado, D. Vicente, M. Salavert, M. Ruiz, I. Ruiz, F. Marco, M. Lizasoain, P. Jiménez-Fonseca, C. Gudiol, J. Cassinello, A. Carmona-Bayonas, M. Aguilar, J. J. Cruz

Published in: Clinical and Translational Oncology | Issue 6/2016

Abstract

An expert group from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC, for its acronym in Spanish) and the Spanish Society of Medical Oncology (SEOM, for its acronym in Spanish) have reviewed the main aspects to be considered when evaluating patients with solid cancer and infectious complications contained in this article. Recommendations have, therefore, been put forth regarding the prophylaxis of the most prevalent infections in these patients, the use of vaccines, measures to control infection through vascular catheters, and preventing infection in light of certain surgical maneuvers. The following is a revision of the criteria for febrile neutropenia management and the use of colony-stimulating factors and closes with several guidelines for treating the cancer patient with serious infection. The document concludes with a series of measures to control hospital infection.

Prevention and treatment of cancer-related infections. Version 1.2013. (2014). http://oralcancerfoundation.org/treatment/pdf/infections.pdf

Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58(3):309–18. doi:10.1093/cid/cit816.CrossRefPubMed

General recommendations on immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. (2011);60:(2):1–64 (pii: rr6002a1). http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21293327

EASL. EASL clinical practice guidelines: management of chronic hepatitis B. J Hepatol. 2009;50(2):227–42. doi:10.1016/j.jhep.2008.10.001.CrossRef

Castellano G, Manzano ML. Tratamiento y profilaxis de la hepatitis B en pacientes inmunosuprimidos. Gastroenterol Hepatol. 2012;35(Espec Congr 1):1–19.

Hwang JP, Somerfield MR, Alston-Johnson DE, Cryer DR, Feld JJ, Kramer BS, et al. Hepatitis B virus screening for patients with cancer before therapy: american society of clinical oncology provisional clinical opinion update. J Clin Oncol. 2015;33(19):2212–20. doi:10.1200/JCO.2015.61.3745.CrossRefPubMed

Targeted tuberculin testing and treatment of latent tuberculosis infection. American Thoracic Society. MMWR Recomm Rep. (2000);49(RR-6):1–51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10881762

Kamboj M, Sepkowitz KA. The risk of tuberculosis in patients with cancer. Clin Infect Dis. 2006;42(11):1592–5. doi:10.1086/503917.CrossRefPubMed

Menzies D, Sterling TR. Treatment of Mycobacterium tuberculosis infection: time to get a move on? Ann Intern Med. 2014;161(6):449–50. doi:10.7326/M14-1719.CrossRefPubMed

10.

Person AK, Pettit AC, Sterling TR. Diagnosis and treatment of latent tuberculosis infection: an update. Curr Respir Care Rep. 2013;2(4):199–207. doi:10.1007/s13665-013-0064-y.CrossRefPubMedPubMedCentral

11.

Redelman-Sidi G, Sepkowitz KA. IFN-gamma release assays in the diagnosis of latent tuberculosis infection among immunocompromised adults. Am J Respir Crit Care Med. 2013;188(4):422–31. doi:10.1164/rccm.201209-1621CI.CrossRefPubMed

12.

Sharma SK, Sharma A, Kadhiravan T, Tharyan P. Rifamycins (rifampicin, rifabutin and rifapentine) compared to isoniazid for preventing tuberculosis in HIV-negative people at risk of active TB. Cochrane Database Syst Rev. 2013;7:CD007545. doi:10.1002/14651858.CD007545.pub2.PubMed

13.

Stagg HR, Zenner D, Harris RJ, Munoz L, Lipman MC, Abubakar I. Treatment of latent tuberculosis infection: a network meta-analysis. Ann Intern Med. 2014;161(6):419–28. doi:10.7326/M14-1019.CrossRefPubMed

14.

Lorente L, Henry C, Martin MM, Jimenez A, Mora ML. Central venous catheter-related infection in a prospective and observational study of 2,595 catheters. Crit Care. 2005;9(6):R631–5. doi:10.1186/cc3824.CrossRefPubMedPubMedCentral

15.

O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):e162–93. doi:10.1093/cid/cir257.CrossRefPubMedPubMedCentral

16.

Schiffer CA, Mangu PB, Wade JC, Camp-Sorrell D, Cope DG, El-Rayes BF, et al. Central venous catheter care for the patient with cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2013;31(10):1357–70. doi:10.1200/JCO.2012.45.5733.CrossRefPubMed

17.

Ranson MR, Oppenheim BA, Jackson A, Kamthan AG, Scarffe JH. Double-blind placebo controlled study of vancomycin prophylaxis for central venous catheter insertion in cancer patients. J Hosp Infect. 1990;15(1):95–102 0195-6701(90)90025-J [pii].CrossRefPubMed

18.

Banerjee S, Shen B, Baron TH, Nelson DB, Anderson MA, Cash BD, et al. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc. 2008;67(6):791–8. doi:10.1016/j.gie.2008.02.068.CrossRefPubMed

19.

Jain NK, Larson DE, Schroeder KW, Burton DD, Cannon KP, Thompson RL, et al. Antibiotic prophylaxis for percutaneous endoscopic gastrostomy. A prospective, randomized, double-blind clinical trial. Ann Intern Med. 1987;107(6):824–8.CrossRefPubMed

20.

Sepkowitz KA. Pneumocystis carinii pneumonia in patients without AIDS. Clin Infect Dis. 1993;17(Suppl 2):S416–22.CrossRefPubMed

21.

Green H, Paul M, Vidal L, Leibovici L. Prophylaxis of Pneumocystis pneumonia in immunocompromised non-HIV-infected patients: systematic review and meta-analysis of randomized controlled trials. Mayo Clin Proc. 2007;82(9):1052–9. doi:10.4065/82.9.1052.CrossRefPubMed

22.

Hughes WT, Rivera GK, Schell MJ, Thornton D, Lott L. Successful intermittent chemoprophylaxis for Pneumocystis carinii pneumonitis. N Engl J Med. 1987;316(26):1627–32. doi:10.1056/NEJM198706253162604.CrossRefPubMed

23.

Colby C, McAfee S, Sackstein R, Finkelstein D, Fishman J, Spitzer T. A prospective randomized trial comparing the toxicity and safety of atovaquone with trimethoprim/sulfamethoxazole as Pneumocystis carinii pneumonia prophylaxis following autologous peripheral blood stem cell transplantation. Bone Marrow Transplant. 1999;24(8):897–902. doi:10.1038/sj.bmt.1702004.CrossRefPubMed

24.

DeMasi JM, Cox JA, Leonard D, Koh AY, Aquino VM. Intravenous pentamidine is safe and effective as primary pneumocystis pneumonia prophylaxis in children and adolescents undergoing hematopoietic stem cell transplantation. Pediatr Infect Dis J. 2013;32(9):933–6. doi:10.1097/INF.0b013e318292f560.CrossRefPubMed

25.

Marras TK, Sanders K, Lipton JH, Messner HA, Conly J, Chan CK. Aerosolized pentamidine prophylaxis for Pneumocystis carinii pneumonia after allogeneic marrow transplantation. Transpl Infect Dis. 2002;4(2):66–74 (pii: 0o008).CrossRefPubMed

26.

Keiser PB, Nutman TB. Strongyloides stercoralis in the immunocompromised population. Clin Microbiol Rev. 2004;17(1):208–17.CrossRefPubMedPubMedCentral

27.

Martinez-Perez A, Norman FF, Monge-Maillo B, Perez-Molina JA, Lopez-Velez R. An approach to the management of Trypanosoma cruzi infection (Chagas’ disease) in immunocompromised patients. Expert Rev Anti Infect Ther. 2014;12(3):357–73. doi:10.1586/14787210.2014.880652.CrossRefPubMed

28.

Kuderer NM, Dale DC, Crawford J, Lyman GH. Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review. J Clin Oncol. 2007;25(21):3158–67. doi:10.1200/JCO.2006.08.8823.CrossRefPubMed

29.

Crawford J, Caserta C, Roila F. Hematopoietic growth factors: ESMO clinical practice guidelines for the applications. Ann Oncol. 2010;21(Suppl 5):v248–51. doi:10.1093/annonc/mdq195.CrossRefPubMed

30.

Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2011;52(4):e56–93. doi:10.1093/cid/cir073.CrossRefPubMed

31.

Berghmans T, Paesmans M, Lafitte JJ, Mascaux C, Meert AP, Jacquy C, et al. Therapeutic use of granulocyte and granulocyte-macrophage colony-stimulating factors in febrile neutropenic cancer patients. A systematic review of the literature with meta-analysis. Support Care Cancer. 2002;10(3):181–8. doi:10.1007/s00520-001-0312-5.CrossRefPubMed

32.

Clark OA, Lyman GH, Castro AA, Clark LG, Djulbegovic B. Colony-stimulating factors for chemotherapy-induced febrile neutropenia: a meta-analysis of randomized controlled trials. J Clin Oncol. 2005;23(18):4198–214. doi:10.1200/JCO.2005.05.645.CrossRefPubMed

33.

Kuderer NM, Dale DC, Crawford J, Cosler LE, Lyman GH. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer. 2006;106(10):2258–66. doi:10.1002/cncr.21847.CrossRefPubMed

34.

Cullen M, Steven N, Billingham L, Gaunt C, Hastings M, Simmonds P, et al. Antibacterial prophylaxis after chemotherapy for solid tumors and lymphomas. N Engl J Med. 2005;353(10):988–98. doi:10.1056/NEJMoa050078.CrossRefPubMed

35.

Gafter-Gvili A, Fraser A, Paul M, Leibovici L. Meta-analysis: antibiotic prophylaxis reduces mortality in neutropenic patients. Ann Intern Med. 2005;142(12 Pt 1):979–95 (pii: 142/12_Part_1/979).CrossRefPubMed

36.

Bucaneve G, Micozzi A, Menichetti F, Martino P, Dionisi MS, Martinelli G, et al. Levofloxacin to prevent bacterial infection in patients with cancer and neutropenia. N Engl J Med. 2005;353(10):977–87. doi:10.1056/NEJMoa044097.CrossRefPubMed

37.

Bow EJ. Fluoroquinolones, antimicrobial resistance and neutropenic cancer patients. Curr Opin Infect Dis. 2011;24(6):545–53. doi:10.1097/QCO.0b013e32834cf054.CrossRefPubMed

38.

Carratala J, Fernandez-Sevilla A, Tubau F, Callis M, Gudiol F. Emergence of quinolone-resistant Escherichia coli bacteremia in neutropenic patients with cancer who have received prophylactic norfloxacin. Clin Infect Dis. 1995;20(3):557–60 (discussion 561–553).CrossRefPubMed

39.

Flowers CR, Seidenfeld J, Bow EJ, Karten C, Gleason C, Hawley DK, et al. Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2013;31(6):794–810. doi:10.1200/JCO.2012.45.8661.CrossRefPubMed

40.

Kern WV, Andriof E, Oethinger M, Kern P, Hacker J, Marre R. Emergence of fluoroquinolone-resistant Escherichia coli at a cancer center. Antimicrob Agents Chemother. 1994;38(4):681–7.CrossRefPubMedPubMedCentral

41.

Neumann S, Krause SW, Maschmeyer G, Schiel X, von Lilienfeld-Toal M. Primary prophylaxis of bacterial infections and Pneumocystis jirovecii pneumonia in patients with hematological malignancies and solid tumors: Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Ann Hematol. 2013;92(4):433–42. doi:10.1007/s00277-013-1698-0.CrossRefPubMedPubMedCentral

42.

Pepin J, Saheb N, Coulombe MA, Alary ME, Corriveau MP, Authier S, et al. Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec. Clin Infect Dis. 2005;41(9):1254–60. doi:10.1086/496986.CrossRefPubMed

43.

Cullen M, Baijal S. Prevention of febrile neutropenia: use of prophylactic antibiotics. Br J Cancer. 2009;101(Suppl 1):S11–4. doi:10.1038/sj.bjc.6605270.CrossRefPubMedPubMedCentral

44.

Tjan-Heijnen VC, Postmus PE, Ardizzoni A, Manegold CH, Burghouts J, van Meerbeeck J, et al. Reduction of chemotherapy-induced febrile leucopenia by prophylactic use of ciprofloxacin and roxithromycin in small-cell lung cancer patients: an EORTC double-blind placebo-controlled phase III study. Ann Oncol. 2001;12(10):1359–68.CrossRefPubMed

45.

Mayordomo JI, Lopez A, Vinolas N, Castellanos J, Pernas S, Domingo Alonso J, et al. Retrospective cost analysis of management of febrile neutropenia in cancer patients in Spain. Curr Med Res Opin. 2009;25(10):2533–42. doi:10.1185/03007990903209563.CrossRefPubMed

46.

Klastersky J, Paesmans M, Georgala A, Muanza F, Plehiers B, Dubreucq L, et al. Outpatient oral antibiotics for febrile neutropenic cancer patients using a score predictive for complications. J Clin Oncol. 2006;24(25):4129–34. doi:10.1200/JCO.2005.03.9909.CrossRefPubMed

47.

Carmona-Bayonas A, Gomez J, Gonzalez-Billalabeitia E, Canteras M, Navarrete A, Gonzalvez ML, et al. Prognostic evaluation of febrile neutropenia in apparently stable adult cancer patients. Br J Cancer. 2011;105(5):612–7. doi:10.1038/bjc.2011.284.CrossRefPubMedPubMedCentral

48.

Talcott JA, Finberg R, Mayer RJ, Goldman L. The medical course of cancer patients with fever and neutropenia. Clinical identification of a low-risk subgroup at presentation. Arch Intern Med. 1988;148(12):2561–8.CrossRefPubMed

49.

Teuffel O, Ethier MC, Alibhai SM, Beyene J, Sung L. Outpatient management of cancer patients with febrile neutropenia: a systematic review and meta-analysis. Ann Oncol. 2011;22(11):2358–65. doi:10.1093/annonc/mdq745.CrossRefPubMed

50.

Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580–637. doi:10.1097/CCM.0b013e31827e83af.CrossRefPubMed

51.

Carmona-Bayonas A, Jimenez-Fonseca P, Virizuela Echaburu J, Antonio M, Font C, Biosca M, et al. Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the Clinical Index of Stable Febrile Neutropenia in a prospective cohort of patients from the FINITE study. J Clin Oncol. 2015;33(5):465–71. doi:10.1200/JCO.2014.57.2347.CrossRefPubMed

52.

Kern WV, Marchetti O, Drgona L, Akan H, Aoun M, Akova M, et al. Oral antibiotics for fever in low-risk neutropenic patients with cancer: a double-blind, randomized, multicenter trial comparing single daily moxifloxacin with twice daily ciprofloxacin plus amoxicillin/clavulanic acid combination therapy—EORTC infectious diseases group trial XV. J Clin Oncol. 2013;31(9):1149–56. doi:10.1200/JCO.2012.45.8109.CrossRefPubMed

53.

Paul M, Dickstein Y, Borok S, Vidal L, Leibovici L. Empirical antibiotics targeting Gram-positive bacteria for the treatment of febrile neutropenic patients with cancer. Cochrane Database Syst Rev. 2014;1:CD003914. doi:10.1002/14651858.CD003914.pub3.PubMed

54.

Paul M, Soares-Weiser K, Grozinsky S, Leibovici L. Beta-lactam versus beta-lactam-aminoglycoside combination therapy in cancer patients with neutropenia. Cochrane Database Syst Rev. 2003;3:CD003038. doi:10.1002/14651858.CD003038.PubMed

55.

Gudiol C, Tubau F, Calatayud L, Garcia-Vidal C, Cisnal M, Sanchez-Ortega I, et al. Bacteraemia due to multidrug-resistant Gram-negative bacilli in cancer patients: risk factors, antibiotic therapy and outcomes. J Antimicrob Chemother. 2011;66(3):657–63. doi:10.1093/jac/dkq494.CrossRefPubMed

56.

Marin M, Gudiol C, Garcia-Vidal C, Ardanuy C, Carratala J. Bloodstream infections in patients with solid tumors: epidemiology, antibiotic therapy, and outcomes in 528 episodes in a single cancer center. Medicine (Baltimore). 2014;93(3):143–9. doi:10.1097/MD.0000000000000026.CrossRef

57.

Averbuch D, Orasch C, Cordonnier C, Livermore DM, Mikulska M, Viscoli C, et al. European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European conference on infections in leukemia. Haematologica. 2013;98(12):1826–35. doi:10.3324/haematol.2013.091025.CrossRefPubMedPubMedCentral

58.

Meidani M, Khorvash F, Abolghasemi H, Jamali B. Procalcitonin and quantitative C-reactive protein role in the early diagnosis of sepsis in patients with febrile neutropenia. South Asian J Cancer. 2013;2(4):216–9. doi:10.4103/2278-330X.119913.CrossRefPubMedPubMedCentral

59.

Jimeno A, Garcia-Velasco A, del Val O, Gonzalez-Billalabeitia E, Hernando S, Hernandez R, et al. Assessment of procalcitonin as a diagnostic and prognostic marker in patients with solid tumors and febrile neutropenia. Cancer. 2004;100(11):2462–9. doi:10.1002/cncr.20275.CrossRefPubMed

60.

Sakr Y, Sponholz C, Tuche F, Brunkhorst F, Reinhart K. The role of procalcitonin in febrile neutropenic patients: review of the literature. Infection. 2008;36(5):396–407. doi:10.1007/s15010-008-7374-y.CrossRefPubMed

Title: Management of infection and febrile neutropenia in patients with solid cancer
Authors: J. A. Virizuela
J. Carratalà
J. M. Aguado
D. Vicente
M. Salavert
M. Ruiz
I. Ruiz
F. Marco
M. Lizasoain
P. Jiménez-Fonseca
C. Gudiol
J. Cassinello
A. Carmona-Bayonas
M. Aguilar
J. J. Cruz
Publication date: 01-06-2016
Publisher: Springer Milan
Published in: Clinical and Translational Oncology / Issue 6/2016
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI: https://doi.org/10.1007/s12094-015-1442-4

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