Primary prophylaxis of bacterial infections and Pneumocystis jirovecii pneumonia in patients with hematologic malignancies and solid tumors: 2020 updated guidelines of the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology (AGIHO/DGHO)
DGHO-AGIHO · 2021 · Germany
Source and licence
- Authors
- Annika Y Classen, Larissa Henze, Marie von Lilienfeld-Toal et al.
- Title
- Primary prophylaxis of bacterial infections and Pneumocystis jirovecii pneumonia in patients with hematologic malignancies and solid tumors: 2020 updated guidelines of the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology (AGIHO/DGHO)
- Journal
- Annals of Hematology, 2021
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC8116237
Licence statement of the original publication
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This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.
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Recommendations
Verbatim, with grade of recommendation or strength of consensus where given.
Recent warnings regarding fluoroquinolone safety
- We advise physicians to inform patients about potential FQ side effects and discuss the risks and benefits of alternative strategies, i.e., standard-dose TMP-SMX (more acute side effects), an oral third-generation cephalosporin (lack of evidence), or no antibiotic prophylaxis (increased risk of fever and hospitalization).
Abstract
Hematologic and oncologic patients with chemo- or immunotherapy-related immunosuppression are at substantial risk for bacterial infections and Pneumocystis jirovecii pneumonia (PcP). As bacterial resistances are increasing worldwide and new research reshapes our understanding of the interactions between the human host and bacterial commensals, administration of antibacterial prophylaxis has become a matter of discussion. This guideline constitutes an update of the 2013 published guideline of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO). It gives an overview about current strategies for antibacterial prophylaxis in cancer patients while taking into account the impact of antibacterial prophylaxis on the human microbiome and resistance development. Current literature published from January 2012 to August 2020 was searched and evidence-based recommendations were developed by an expert panel. All recommendations were discussed and approved in a consensus conference of the AGIHO prior to publication. As a result, we present a comprehensive update and extension of our guideline for antibacterial and PcP prophylaxis in cancer patients.
Supplementary Information: The online version contains supplementary material available at 10.1007/s00277-021-04452-9.
Contents of the original publication
The section headings of the original.
- Introduction
- Methods
- Patients and risk factors
- New anti-cancer agents and antibacterial prophylaxis
- Spectrum of pathogens in infections of neutropenic patients
- Resistance development
- Novel considerations regarding microbiome and resistome
- Efficacy of prophylaxis
- Duration of prophylaxis administration
- Drugs for antibacterial prophylaxis
- Recent warnings regarding fluoroquinolone safety
- Selective digestive tract decontamination
- Indication for Pneumocystis jirovecii prophylaxis
- Choice of drugs and doses for PcP prophylaxis
- Materials availability
- Code availability
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