Antimicrobials in patients with hematologic malignancies and recipients of hematopoietic cell transplantation and other cellular therapies

Author:

Tverdek Frank123ORCID,Escobar Zahra Kassamali123ORCID,Liu Catherine14ORCID,Jain Rupali234ORCID,Lindsay Julian15ORCID

Affiliation:

1. Vaccine and Infectious Disease Division Fred Hutchinson Cancer Center Seattle Washington USA

2. Department of Pharmacy University of Washington Medicine Seattle Washington USA

3. School of Pharmacy University of Washington Seattle Washington USA

4. Division of Allergy and Infectious Diseases University of Washington Seattle Washington USA

5. National Centre for Infection in Cancer and Transplantation (NCICT) Peter MacCallum Cancer Centre Melbourne Victoria Australia

Abstract

AbstractBackgroundAppropriate use of antimicrobials for hematologic malignancy, hematopoietic stem cell transplant recipients, and other cellular therapies is vital, with infection causing significant morbidity and mortality in this unique population of immunocompromised hosts. However, often in this population the choice and management of antimicrobial therapy is complex. When selecting an antimicrobial agent, key considerations include the need for dose adjustments due to renal or hepatic impairment, managing drug interactions, the potential for additive drug toxicity among those receiving polypharmacy and therapeutic drug monitoring. Other factors include leveraging pharmacodynamic principles to enable optimization of directed therapy against challenging pathogens, as well as judicious use of antimicrobials to limit drug resistance and adverse drug reactions.SummaryThis review summarizes the clinical considerations for commonly used antimicrobials in this setting, including antibacterial, antiviral, and antifungal agents. image

Publisher

Wiley

Subject

Infectious Diseases,Transplantation

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