Infection prevention in severely myelosuppressed patients: A comparison between ciprofloxacin and a regimen of selective antibiotic modulation of the intestinal flora

摘要: Abstract purpose: To study whether oral ciprofloxacin would be as effective in preventing bacterial infections severely myelosuppressed patients selective antibiotic modulation of the gut flora with neomycin/polymyxin B sulfate/nalidixic acid (NPN). and methods: One hundred five undergoing allogeneic or autologous bone marrow transplant, induction therapy for acute leukemia 1988 1989 were studied. Patients stratified according to type therapy, randomized a ratio 2:1 either 500 mg BID, combination neomycin 250 QID, polymyxin-B 100 nalidixic 1,000 BID. Treatment began on admission continued until absolute granulocyte count was greater than 500/mm 3 consecutive days. results: The 96 evaluable evenly distributed over treatment groups; 63 received 33 NPN. Fever developed 92% 97% NPN ( P = 0.66), 6.6 ± 5.8 7.2 5.3 days from start prophylaxis, respectively. Twenty=five 29 microbiologically documented infections, fewer 26 22 0.02). had bacteremias (33%) did (55%) 0.05). Gram-negative very rare (2 cases; no Enterobacteriaceae ), but streptococcal frequent both arms (27 cases). Side effects not significantly different, compliance better. conclusions: Ciprofloxacin is at least neomycin/polymyxin/nalidixic prophylaxis patients, better tolerated. Additional agents prevent are needed.