Targeted therapy against multi-resistant bacteria in leukemic and hematopoietic stem cell transplant recipients: Guidelines of the 4th European conference on Infections in Leukemia (ECIL-4, 2011)

Diana Averbuch, Catherine Cordonnier, David M. Livermore, Małgorzata Mikulska, Christina Orasch, Claudio Viscoli, Inge C. Gyssens, Winfried V. Kern, Galina Klyasova, Oscar Marchetti, Dan Engelhard, Murat Akova

Research output: Contribution to journalArticle

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Abstract

The detection of multi-resistant bacterial pathogens, particularly those to carbapenemases, in leukemic and stem cell transplant patients forces the use of old or non-conventional agents as the only remaining treatment options. These include colistin/polymyxin B, tigecycline, fosfomycin and various anti-gram-positive agents. Data on the use of these agents in leukemic patients are scanty, with only linezolid subjected to formal trials. The Expert Group of the 4th European Conference on Infections in Leukemia has developed guidelines for their use in these patient populations. Targeted therapy should be based on (i) in vitro susceptibility data, (ii) knowledge of the best treatment option against the particular species or phenotype of bacteria, (iii) pharmacokinetic/pharmacodynamic data, and (iv) careful assessment of the risk-benefit balance. For infections due to resistant Gram-negative bacteria, these agents should be preferably used in combination with other agents that remain active in vitro, because of suboptimal efficacy (e.g., tigecy-cline) and the risk of emergent resistance (e.g., fosfomycin). The paucity of new antibacterial drugs in the near future should lead us to limit the use of these drugs to situations where no alternative exists.

Original languageEnglish
Pages (from-to)1836-1847
Number of pages12
JournalHaematologica
Volume98
Issue number12
DOIs
Publication statusPublished - Dec 1 2013

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Hematopoietic Stem Cells
Fosfomycin
Leukemia
Linezolid
Guidelines
Bacteria
Transplants
Infection
Colistin
Polymyxin B
Gram-Negative Bacteria
Pharmaceutical Preparations
Stem Cells
Therapeutics
Pharmacokinetics
Phenotype
Population
Transplant Recipients
In Vitro Techniques

ASJC Scopus subject areas

  • Hematology

Cite this

Targeted therapy against multi-resistant bacteria in leukemic and hematopoietic stem cell transplant recipients : Guidelines of the 4th European conference on Infections in Leukemia (ECIL-4, 2011). / Averbuch, Diana; Cordonnier, Catherine; Livermore, David M.; Mikulska, Małgorzata; Orasch, Christina; Viscoli, Claudio; Gyssens, Inge C.; Kern, Winfried V.; Klyasova, Galina; Marchetti, Oscar; Engelhard, Dan; Akova, Murat.

In: Haematologica, Vol. 98, No. 12, 01.12.2013, p. 1836-1847.

Research output: Contribution to journalArticle

Averbuch, Diana ; Cordonnier, Catherine ; Livermore, David M. ; Mikulska, Małgorzata ; Orasch, Christina ; Viscoli, Claudio ; Gyssens, Inge C. ; Kern, Winfried V. ; Klyasova, Galina ; Marchetti, Oscar ; Engelhard, Dan ; Akova, Murat. / Targeted therapy against multi-resistant bacteria in leukemic and hematopoietic stem cell transplant recipients : Guidelines of the 4th European conference on Infections in Leukemia (ECIL-4, 2011). In: Haematologica. 2013 ; Vol. 98, No. 12. pp. 1836-1847.
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