期刊
FRONTIERS IN MEDICINE
卷 8, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fmed.2021.636547
关键词
sepsis; septic shock; cancer; bacteremia; bloodstream infection; neutropenia; antibiotic resistance
资金
- Plan Nacional de I+D+i 2013-2016
- Instituto de Salud Carlos III, Subdireccion General de Redes y Centros de Investigacion Cooperativa, Ministerio de Ciencia, Innovacion y Universidades, Spanish Network for Research in Infectious Diseases [REIPI RD16/0016/0001]
- European Development Regional Fund A way to achieve Europe, Operative program Intelligent Growth 2014-2020
This review discusses the mechanisms, risk factors, importance of adequate antibiotic therapy, and optimal management of sepsis in immunosuppressed cancer patients and hematopoietic stem cell transplant recipients.
Sepsis is a frequent complication in immunosuppressed cancer patients and hematopoietic stem cell transplant recipients that is associated with high morbidity and mortality rates. The worldwide emergence of antimicrobial resistance is of special concern in this population because any delay in starting adequate empirical antibiotic therapy can lead to poor outcomes. In this review, we aim to address: (1) the mechanisms involved in the development of sepsis and septic shock in these patients; (2) the risk factors associated with a worse prognosis; (3) the impact of adequate initial empirical antibiotic therapy given the current era of widespread antimicrobial resistance; and (4) the optimal management of sepsis, including adequate and early source control of infection, optimized antibiotic use based on the pharmacokinetic and pharmacodynamics changes in these patients, and the role of the new available antibiotics.
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