Management of infections in the outpatient care of patients with cancer

Infections are a common complication in immunocompromised patients with haematological and oncological diseases, including in outpatient settings. They lead to distressing morbidity and can delay or jeopardize the implementation of effective antineoplastic therapy. Identifying risk groups for complicated infections may reduce morbidity and mortality. The prevention of bacterial and viral infections as well as Pneumocystis jirovecii pneumonia through drug prophylaxis and consistent vaccination are essential here. In many cases, precise clinical evaluation of patients with febrile neutropenia allows for outpatient empirical and pre-emptive oral antimicrobial therapy and avoids unnecessary hospital stays. These recommendations are based on guidelines developed by the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) for the prophylaxis, diagnosis, and treatment of these patients, which are available on the Onkopedia platform of the DGHO (www.onkopedia.com). The recommendations are backed-up by systematic literature reviews, uniform assessment of the strength of evidence, and a consensus-building process.