Document Detail


Fungal colonization and invasive fungal infections following allogeneic BMT using metronidazole, ciprofloxacin and fluconazole or ciprofloxacin and fluconazole as intestinal decontamination.
MedLine Citation:
PMID:  11100279     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Invasive fungal infections (IFI) are increasingly diagnosed in patients undergoing allogeneic BMT. We have previously shown that the addition of metronidazole to ciprofloxacin for gastrointestinal bacterial decontamination significantly reduces the incidence of grades II-IV aGVHD by reduction of the anaerobic intestinal bacterial flora. Here, we found that the combined use of ciprofloxacin, metronidazole and fluconazole as antifungal prophylaxis increased intestinal yeast colonization when compared to ciprofloxacin and fluconazole alone (P < 0.01). Based on the EORTC criteria, a total of 18 out of 134 study patients developed IFI: seven of 68 (10%) patients who received metronidazole compared to 11 of the 66 (17%) patients decontaminated without metronidazole developed IFI (log-rank P = 0.36). Lethal IFI occurred in two of seven patients receiving metronidazole and in four of 11 patients without anaerobic decontamination. In conclusion, bacterial intestinal decontamination using metronidazole as an antibiotic with activity against most anaerobic intestinal bacteria significantly increases the intestinal yeast burden without influencing the incidence of IFI in patients undergoing allogeneic BMT.
Authors:
R Trenschel; R Peceny; V Runde; A Elmaagacli; H Dermoumi; E Heintschel von Heinegg; K D Müller; U W Schaefer; D W Beelen
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Bone marrow transplantation     Volume:  26     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2001-02-09     Completed Date:  2001-03-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  993-7     Citation Subset:  IM    
Affiliation:
Department of Bone Marrow Transplantation, University Hospital Essen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-Bacterial Agents / therapeutic use*
Antibiotic Prophylaxis*
Antifungal Agents / therapeutic use*
Aspergillosis / epidemiology,  etiology,  prevention & control
Bacteria, Anaerobic / drug effects,  physiology
Bone Marrow Transplantation*
Candidiasis / epidemiology,  etiology,  prevention & control
Cause of Death
Ciprofloxacin / administration & dosage,  therapeutic use*
Disease Susceptibility
Female
Fluconazole / administration & dosage,  therapeutic use*
Fungemia / epidemiology,  etiology,  prevention & control
Fungi / drug effects,  pathogenicity
Hematologic Neoplasms / complications,  therapy
Humans
Immunocompromised Host
Immunosuppressive Agents / adverse effects*
Incidence
Intestinal Diseases / epidemiology,  etiology,  microbiology,  prevention & control*
Intestines / microbiology*
Male
Metronidazole / administration & dosage,  therapeutic use*
Middle Aged
Mycoses / epidemiology,  etiology,  microbiology,  prevention & control*
Neuroaspergillosis / epidemiology,  etiology,  prevention & control
Opportunistic Infections / epidemiology,  etiology,  microbiology,  prevention & control*
Premedication*
Prospective Studies
Superinfection / epidemiology,  etiology,  microbiology,  prevention & control
Transplantation Conditioning / adverse effects*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Antifungal Agents; 0/Immunosuppressive Agents; 443-48-1/Metronidazole; 85721-33-1/Ciprofloxacin; 86386-73-4/Fluconazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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