Antibiotic resistance in the patient with cancer: Escalating challenges and paths forward

CA Cancer J Clin. 2021 Nov;71(6):488-504. doi: 10.3322/caac.21697. Epub 2021 Sep 21.

Abstract

Infection is the second leading cause of death in patients with cancer. Loss of efficacy in antibiotics due to antibiotic resistance in bacteria is an urgent threat against the continuing success of cancer therapy. In this review, the authors focus on recent updates on the impact of antibiotic resistance in the cancer setting, particularly on the ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.). This review highlights the health and financial impact of antibiotic resistance in patients with cancer. Furthermore, the authors recommend measures to control the emergence of antibiotic resistance, highlighting the risk factors associated with cancer care. A lack of data in the etiology of infections, specifically in oncology patients in United States, is identified as a concern, and the authors advocate for a centralized and specialized surveillance system for patients with cancer to predict and prevent the emergence of antibiotic resistance. Finding better ways to predict, prevent, and treat antibiotic-resistant infections will have a major positive impact on the care of those with cancer.

Keywords: antibiotic resistance; antibiotics; bacterial infections; cancer.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antimicrobial Stewardship
  • Drug Resistance, Multiple, Bacterial*
  • Humans
  • Immunocompromised Host
  • Neoplasms / complications*
  • Opportunistic Infections / prevention & control
  • Prescription Drug Misuse / prevention & control

Substances

  • Anti-Bacterial Agents