Abstract
SummaryMultidrug resistance of bacterial pathogens is an increasing problem wordwide, especially treatment of multidrug resistant (MDR) gramnegative bacteria is challenging. In the recent past, several new antibiotics as well as new betalactamase inhibitors have been introduced. These novel drugs are valuable new tools for the therapy of infectious complications in cancer patients once there is a high risk for infections due to multidrug-resistant pathogens. While it is necessary to start empirical antibiotic therapy immediately, novel antibiotics only provide benefits in certain situations, depending on the underlying pathogens. Thus, these new antibiotics are best used guided by microbiological testing, since the exact mechanism of resistance determines susceptibility or resistance to certain antibiotics. For empirical therapy, previous culture results and/or colonization with MDR pathogens can help to choose from conventional antibiotics or novel drugs. In clinical practice, optimal antibiotic therapy can be achieved by close collaboration of specialists in hematooncology, infectious diseases and microbiology.
Highlights
Patients with hematologic neoplasias and solid tumors are at increased risk for different kinds of infections due to both common and opportunistic pathogens
Much less is known about the best possible treatment of multidrug resistant (MDR) bacteria in cancer patients
When MDR gramnegative bacilli could be identified as the causative pathogen, a study by Martinez-Nadal found that approximately 40% of neutropenic patients with bacteremia were treated with inappropriate empirical antibiotics, despite choosing treatment regimens suggested by international guidelines
Summary
Received: 20 January 2021 / Accepted: 2 March 2021 / Published online: 1 April 2021. Summary Multidrug resistance of bacterial pathogens is an increasing problem wordwide, especially treatment of multidrug resistant (MDR) gramnegative bacteria is challenging. Several new antibiotics as well as new betalactamase inhibitors have been introduced These novel drugs are valuable new tools for the therapy of infectious complications in cancer patients once there is a high risk for infections due to multidrug-resistant pathogens. While it is necessary to start empirical antibiotic therapy immediately, novel antibiotics only provide benefits in certain situations, depending on the underlying pathogens. These new antibiotics are best used guided by microbiological testing, since the exact mechanism of resistance determines susceptibility or resistance to certain antibiotics. Keywords New antibiotics · Microbiological testing · Multidrug resistance · Bacterial infections · Febrile neutropenia. Complicated urinary infections Extended spectrum betalactamase Hospital-acquired bacterial pneumonia Metallo-betalactamase Multidrug-resistant Methicillin-resistant S. aureus Skin and skin structure infections Trimethoprim-sulfamethoxazole
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