Klin Onkol 1998; 11(5): 137-143.
Abstract: In cancer patients, severe immunodeficiency is very frequent finding. It can be caused by basic disease, therapy, or both, perhaps most dangerous ist deep neutropenia. Accompanied by fever, it is called febrile neutropenia and this condition needs prompt starting of antibiotic therapy even in situations with no definite proof of infection (eg. empirical treatment). In recent years, we have cnocontered an increasing frequency of gram-positive infections, caused predominancy by coagula-se negative staphylococci and streptococci. It is believed that this increase is caused by massive usage of intravenous catheters, mucositis after high dose chemotherapies, and prophylactic administration of antibiotics against gram-negative bacteria. New pathogens, eg. Rhodococcus, Leuconostoc and Corynebacterium jejkeium are emerging. Vancomycin plays the crucial role in the treatment of all these gram-positive infections. In comparison with gram-negative infections, gram-positive infectiens exhibit lower mortality, but morbidity is very high.
In this review, vancomycin is characterized and studies concerning usage of this antibiotic are discussed in detail. Both possibilities, early or delayed administration of vancomycin arc discussed. Prophylactic administration is rare. In comparison with is predecesor, today's vancomycin is non-toxic, probably due to improved purification. Development of resistance to vancomycin is also disenssed.
