Our studies are devoted to developing methods to define cancer patient 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 beta-lactams and the quinolones. We have shown that certain beta-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 the role of oral antibiotic therapy; the necessary duration of empiric therapy for patients with unexplained fevers and the choice of empiric antifungal therapy. In addition, we are studying the best type of indwelling catheter to use in the cancer patient and how to manage their related side effects. 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 preparation that contains activity against the Enterobacteriaceae as well as the pseudomonads. We are also studying other immunoregulatory agents that may serve as adjuncts to the treatment of infection, including interleukin 1 and 2, GM- CSF, G-CSF and M-CSF. We have completed Phase I trials with the anti-retroviral agent, azidothymidine for children with AIDS or ARC and have initiated Phase I trials with DOC and with the combination of AZT plus GM- CSF.
