New antimicrobial agents for the treatment of bacterial infections in cancer patients.

Patients with cancer develop serious bacterial infections often, especially during periods of severe and prolonged neutropenia. Antibiotic usage for the prevention and treatment of bacterial infections in these high-risk patients leads to selection pressures resulting in the emergence and spread of resistant organisms. Many organisms acquire several resistance mechanisms, making them multi-drug-resistant (MDR) (defined as resistance to three or more different classes of antibiotics). These infections are associated with increased morbidity, mortality and costs. The development of novel antimicrobial agents with activity against pathogens that have become resistant to currently available agents is one strategy for combating resistant organisms. Several novel agents have either recently been approved, or are in various stages of development and are discussed in detail. It is unlikely that these agents will have a major impact on reducing the development and spread of MDR organisms. Consequently, the judicious use of currently available agents referred to as Antimicrobial Stewardship, and the development of and adherence to appropriate Infection Control policies and procedures are vital components in the management of these high-risk patients.