Our studies are devoted to developing methods to define cancer patients who are at risk for developing serious infection, to improving the ability to diagnose these infections early, to treat them effectively, and ultimately to prevent them. We are developing new therapeutic approaches based on the availability of new antibiotics, particularly the -lactams and the quinolones. We have shown that certain -lactams used as single agents can replace the need for combination antibiotic therapy. Our studies are also defining the appropriate antibiotic therapy for documented infections, particularly include the role of oral antibiotic therapy; the necessary duration of empiric therapy for patients with unexplained fevers, the choice of empiric antifungal therapy, the appropriate approach to the patient with interstitial pulmonary infiltrates. In addition, we are studying the best type of indwelling catheter to use in the cancer patient and how to manage their related side effect. We have developed a unique model for studying the pathophysiology, natural history, treatment and prevention of invasive candidiasis in the neutropenic host. This model permits the testing of new antifungal agents as well as immunoregulatory agents. To prevent infections we are evaluating the role of passive immunization with a pooled immunoglobulin peparation that contains activity against the Enterobacteriacease as well as the pseudomonads.
