How are infections treated in acute lymphoblastic leukemia (ALL)?

Updated: Oct 23, 2019
  • Author: Karen Seiter, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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Answer

Answer

Most patients are neutropenic and immunocompromised

Afebrile patients usually receive prophylactic antibiotics, such as ciprofloxacin (or levofloxacin) and acyclovir (or valacyclovir), and an azole antifungal (posaconazole, voriconazole, itraconazole, or fluconazole) during induction therapy

Febrile neutropenic patients require prompt initiation of broad-spectrum antibiotics

Suggested regimens include a third- or fourth-generation cephalosporin or carbapenem with or without vancomycin

Antibiotics can be modified based on response to therapy; additional antibiotics might be needed for resistant organisms (eg, vancomycin-resistant enterococci [VRE]) or suspected fungal infections


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