Critical appraisal of antimicrobials for prevention of infections in immunocompromised hosts

Infections remain a common cause of morbidity and mortality among patients receiving antineoplastic chemotherapy. Over the past 30 years a number of techniques have been evaluated in an attempt to reduce the incidence of bacterial, fungal, and viral infections. Protective isolation, oral nonabsorbable antibiotics, and selective decontamination of the gastrointestinal tract have all been extensively evaluated. More recently, newer antimicrobial agents have been employed, such as quinolones, imidazoles, and recombinant monoclonal agents for modulation of the immune cascade. A critical review of the advantages and disadvantages of each of these methodologies is presented.