Infectious morbidity in gynecologic oncology

Infectious complications are the most frequent cause of death in cancer patients. Broad-spectrum antibacterial therapy is dictated by the polymicrobial nature of infections encountered in gynecologic oncology and is imperative in the empiric therapy of febrile granulocytopenic patients. In addition, the potential for infectious complications after radical pelvic surgery to remove malignancies has influenced most gynecologic oncologists to recommend prophylactic antibiotics. However, the choice of appropriate antibacterial therapy in gynecologic oncology patients is complicated frequently by impaired renal function secondary to cancer chemotherapy or associated with age in this generally elderly population. In addition, the potential cost- and time-saving advantages of simplified antibacterial regimens have resulted in a reexamination of the standard aminoglycoside-containing multiple-drug regimens. The efficacy and safety of monotherapy with broad-spectrum beta-lactam antibiotics or beta-lactam-antibiotic/beta-lactamase-inhibitor combinations, such as ticarcillin/clavulanate, remain to be confirmed in gynecologic oncology patients. The broad spectrum of ticarcillin/clavulanate, including gram-negative and -positive aerobic and anaerobic bacteria, seems plausible for the treatment of these potentially devastating infections.