Guidelines for Complications of Cancer Treatment Vol VIII Part B

Zygomycosis and other mold infections:Frequency of zygomycosis infection appears to be increasing.There is no level 1 evidence for treatment recommendation.These patients should receive amphotericin B (Preferably lipidpreparation) and aggressive surgical debridement. InvasiveFusarium infection needs treatment with voriconazole,amphotericin B ( preferably lipid preparation). Scedosporiumspecies are resistant to amphotericin B and they need to betreated with Itraconazole or voriconazole.Prophylaxis for infections- (level-1)Antibacterial prophylaxis during neutropenia:There has been evidence of antibiotic prophylaxis decreasingthe risk of all cause mortality, infection related mortality. Thereare important risk involved with its use. There are immediateside effects, potential for selection of resistant organism. Atpresent fluoroquinolones may be used in patients with expectedduration of neutropenia for more than 7 days. It is alsoimportant to review the resistant pattern for thefluoroquinolones at the individual center before starting theuse of this drug.381