Staphylococcal bacteremia in cancer patients: intravenous and oral antimicrobial therapy

Eighteen adult cancer patients with 21 episodes of staphylococcal bacteremia were treated with sequential intravenous and oral antimicrobial agents. Adequacy of antimicrobial therapy was monitored with serum antibacterial activity studies. The mean duration of intravenous and oral therapy was nine and 25 days, respectively. Clinical and bacteriologic cures were achieved in all cases except one, in which relapse occurred after only 16 days of therapy. One patient had staphylococcal endocarditis and one had staphylococcal pneumonia. Four patients died of causes unrelated to staphylococcal bacteremia after 12, 21, 27, and 40 days of therapy, respectively. Initial intravenous therapy followed by oral antimicrobial agents to complete treatment, monitored with serum antibacterial activity studies, is effective therapy for patients with cancer and staphylococcal bacteremia.