Expert insights: 10 key questions on managing common infections in cancer care in India

Cancer patients are at a heightened risk of infections due to immunosuppression from chemotherapy, radiotherapy and the malignancy itself, contributing to increased morbidity and mortality. Effective infection management in this vulnerable population requires a systematic and timely approach to diagnosis and treatment. This review addresses ten critical questions concerning the management of infections in cancer patients, synthesising insights from clinical guidelines, expert opinions and current evidence. The review begins by discussing the optimal diagnostic workup for neutropenic patients, including investigations, risk stratification and treatment approaches for various neutropenia-specific syndromes. It further explores the principles of antibiotic escalation and de-escalation for gram-negative infections, emphasising the need for tailored therapeutic strategies. Advances in microbiological diagnostics, such as early detection methods and understanding resistance mechanisms in gram-negative organisms and Clostridioides difficile infections, are analysed in dedicated sections. The role of radiological investigations, which remain the cornerstone for diagnosing infections in immunocompromised patients, has been addressed. Catheter-related blood stream infection and the role of surveillance culture are explored in the final section. By addressing these critical questions, this review provides oncology clinicians with practical, evidence-based guidance for preventing, diagnosing and managing infections in cancer patients. The insights presented aim to enhance clinical outcomes and ensure patient safety in this high-risk population.