|Fungal colonization and invasive fungal infections following allogeneic BMT using metronidazole, ciprofloxacin and fluconazole or ciprofloxacin and fluconazole as intestinal decontamination.|
|PMID: 11100279 Owner: NLM Status: MEDLINE|
|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.|
|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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|Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial|
|Title: Bone marrow transplantation Volume: 26 ISSN: 0268-3369 ISO Abbreviation: Bone Marrow Transplant. Publication Date: 2000 Nov|
|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|
|Languages: eng Pagination: 993-7 Citation Subset: IM|
|Department of Bone Marrow Transplantation, University Hospital Essen, Germany.|
|APA/MLA Format Download EndNote Download BibTex|
Anti-Bacterial Agents / therapeutic use*
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*
Fluconazole / administration & dosage, therapeutic use*
Fungemia / epidemiology, etiology, prevention & control
Fungi / drug effects, pathogenicity
Hematologic Neoplasms / complications, therapy
Immunosuppressive Agents / adverse effects*
Intestinal Diseases / epidemiology, etiology, microbiology, prevention & control*
Intestines / microbiology*
Metronidazole / administration & dosage, therapeutic use*
Mycoses / epidemiology, etiology, microbiology, prevention & control*
Neuroaspergillosis / epidemiology, etiology, prevention & control
Opportunistic Infections / epidemiology, etiology, microbiology, prevention & control*
Superinfection / epidemiology, etiology, microbiology, prevention & control
Transplantation Conditioning / adverse effects*
|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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