title: Management of gram-positive bacterial infections in patients with cancer.
abstract: Bacterial infections, particularly those due to gram-positive bacteria, continue to predominate in patients with cancer. Coagulase-negative and coagulase-positive staphylococci and enterococci remain as common pathogenic microorganisms. Clostridium difficile has emerged as a significant pathogen. Major clinical syndromes include vascular catheter-related infection, febrile neutropenia, diarrhea and colitis. Rising antimicrobial resistance among gram-positive bacteria is of serious concern. The clinical utility of penicillin against streptococci and vancomycin against coagulase-negative and coagulase-positive staphylococci and enterococci may be rapidly diminishing. Liberal empiric use of vancomycin during neutropenic fever needs careful reconsideration. Newer promising anti-gram-positive bacterial drugs with activity against methicillin-resistant staphylococci include daptomycin, linezolid, tigecycline and telavancin. However, toxicity concerns, limited data in immunocompromised populations and high cost prevent the widespread use of these drugs among patients with cancer.
authors: Division of Infectious Diseases, Wayne State University, Detroit, MI, USA.
authors: Christos I
authors: CI
authors: Kosmidis
authors: Pranatharthi H
authors: PH
authors: Chandrasekar
mesh_terms: D000081:Acetamides / Q000009:adverse effects / Q000627:therapeutic use; D000617:Aminoglycosides / Q000009:adverse effects / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017576:Daptomycin / Q000009:adverse effects / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000187:drug effects; D006094:Gram-Positive Bacteria / Q000187:drug effects*; D016908:Gram-Positive Bacterial Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D000069349:Linezolid; D000077427:Lipoglycopeptides; D008911:Minocycline / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications*; D023303:Oxazolidinones / Q000009:adverse effects / Q000627:therapeutic use; D000078304:Tigecycline
chemical_list: D000081:Acetamides; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000077427:Lipoglycopeptides; D023303:Oxazolidinones; D000078304:Tigecycline; D008911:Minocycline; D000069349:Linezolid; D017576:Daptomycin; C487637:telavancin