| Selective bowel decontamination for the prevention of infection in acute myelogenous leukemia: a prospective randomized trial. | |
| | |
MedLine Citation:
|
PMID: 12014211 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Infection is still a frequent cause of morbidity and mortality in acute myelogenous leukemia (AML) patients receiving chemotherapy. Recently the main cause of infection has changed from gram-negative to gram-positive bacteria and the resistance to antibiotics has increased. This study aimed to access the effectiveness of antimicrobial prophylaxis (AP) with orally absorbable antibiotics. METHODS: Ninety-five AML patients receiving chemotherapy at Catholic Hemopoietic Stem Cell Transplantation Center from March 1999 to July 1999 were randomly divided into the AP group (250 mg ciprofloxacin twice a day, 150 mg roxithromycin twice a day, 50 mg fluconazole once a day) and the control group for a prospective analysis. RESULTS: The incidence of fever was 82.6% in the AP group and 91.6% in the control group (p = 0.15). Though classification and sites of infections showed no difference between the two groups, the catheter associated infection occurred more frequently in the AP group in significance. The time interval between initiation of chemotherapy and onset of fever, white blood cell (WBC) count at the onset of fever, duration of leukopenia (WBC < 1,000/mm3), duration of systemic antibiotic therapy, mortality due to infection and hospitalization period from the data starting chemotherapy showed no differences between the two groups. Infections due to gram negative bacteria decreased to 33.3% in the AP group (vs. 92% in the control group), but infections due to gram positive bacteria increased to 66.7% (vs. 8% in the control group). Gram negative bacteria showed 100% resistance to ciprofloxacin in the AP group and gram-positive bacteria showed 90-100% resistance to erythromycin, regardless of the presence of AP. CONCLUSION: The AP could not reduce the occurrence of infection or infection associated death in AML patients receiving chemotherapy. On considering increased gram-positive infection and resistance to fluoroquinolone and macrolide, routine prescription of AP should be reconsidered. Further studies that assess the effectiveness of AP in other malignancies, aplastic anemia and bone marrow transplantation are required. |
| | |
Authors:
|
Dong Gun Lee; Su Mi Choi; Jung Hyun Choi; Jin Hong Yoo; Yoon Hee Park; Yoo Jin Kim; Seok Lee; Chang Ki Min; Hee Je Kim; Dong Wook Kim; Jong Wook Lee; Woo Sung Min; Wan Shik Shin; Chun Choo Kim |
Publication Detail:
|
Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
|
Title: The Korean journal of internal medicine Volume: 17 ISSN: 1226-3303 ISO Abbreviation: Korean J. Intern. Med. Publication Date: 2002 Mar |
Date Detail:
|
Created Date: 2002-05-16 Completed Date: 2002-06-10 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8712418 Medline TA: Korean J Intern Med Country: Korea (South) |
Other Details:
|
Languages: eng Pagination: 38-44 Citation Subset: IM |
Affiliation:
|
Department of Internal Medicine, Catholic University College of Medicine, Seoul, Korea. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Anti-Infective Agents / therapeutic use* Antibiotic Prophylaxis* Bacterial Infections / epidemiology, etiology, prevention & control* Ciprofloxacin / therapeutic use* Drug Therapy, Combination Female Fever / epidemiology, etiology Fluconazole / therapeutic use Humans Incidence Leukemia, Myeloid, Acute / complications*, drug therapy Male Middle Aged Neutropenia / chemically induced, complications* Prospective Studies Roxithromycin / therapeutic use Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Anti-Infective Agents; 80214-83-1/Roxithromycin; 85721-33-1/Ciprofloxacin; 86386-73-4/Fluconazole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Clinical features of eosinophilic bronchitis.
Next Document: Electron microscopic evaluation of adhesion of Helicobacter pylori to the gastric epithelial cells i...