National Comprehensive Cancer Network. (2011). NCCN Clinical Practice Guidelines in Oncology: Prevention and treatment of cancer-related infections [v.2.2011]. Retrieved from https://www.nccn.org/professionals/physician_gls/pdf/infections.pdf

To provide guidance for clinical practices for the prevention and treatment of infection in patients with cancer.

This resource is a consensus-based guideline.

Patients were undergoing the active antitumor treatment phase of care.

The guideline

• Recommends the consideration of general antibacterial prophylaxis in patients at intermediate and high risk for infection, consideration of antifungal prophylaxis during neutropenia and for anticipated mucosits, and antiviral prophylaxis for intermediate- and high-risk patients.
• Provides suggestions for specific agents for prophylaxis and treatment in various clinical scenarios.
• Outlines treatment and diagnostic/assessment approaches for neutropenic fever and specific clinical presentations.
• Notes that chlorhexidine and sliver sulfadiazine-coated short-term central catheters have been shown to decrease the incidence of catheter colonization and bloodstream infections, but not in patients with hematologic malignancies requiring indwelling catheters for approximately 20 days.
• Notes that vaccination recommendations for transplantation recipients and their household members should be performed.
• Recommends the pneumococcal vaccine in asplenic patients.

The National Comprehensive Cancer Network (NCCN) does not currently endorse the use of a vancomycin lock solution for long-term vascular access devices due to concerns about the emergence of bacterial resistance if widely used. Influenza vaccination with a vaccine that does not use live attenuated organisms can be safely given, and the guideline recommends administration at least two weeks before receiving cytotoxic therapy.

This study lacked high-quality evidence, with most recommendations being based on consensus.

This guideline provided comprehensive references to assess patient risk of infection and expert recommendations regarding interventions aimed at the prevention and treatment of infection in patients with cancer. The guideline does not discuss long-term survivorship issues in this area.