Prevention of Infection in Acute Leukemia: a Prospective Randomized Study on the Efficacy of Two Different Drug Regimens for Antimicrobial Prophylaxis

Overview

Journal Infection

Date 1986 Sep 1

PMID 3491791

Citations 18

Authors

E Kurrle

A W Dekker

W Gaus

E Haralambie

D Krieger

M Rozenberg-Arska

H G de Vries-Hospers

D Van Der Waaij

F Wendt

Affiliations

Soon will be listed here.

Abstract

In a prospective study patients with acute leukemia undergoing remission induction therapy were randomized to receive either a regimen of non-absorbable antimicrobial drugs (colistin and neomycin) or of absorbable and non-absorbable drugs (trimethoprim-sulfamethoxazole [TMP-SMZ] and colistin) for antibacterial prophylaxis. For antifungal prophylaxis patients in both groups were given oral amphotericin B. The proportion of patients without acquired infections and the median of study time to the first acquired infection did not differ significantly between the two treatment groups (p greater than 0.05). Septicemias occurred in nine out of 49 recipients of colistin and neomycin and in one out of 56 patients receiving TMP-SMZ and colistin (p = 0.03). Localized infections and fever episodes without proven infections were equally distributed between the two groups. The incidence of febrile days and of days on parenteral antibiotic therapy was significantly lower in the group given TMP-SMZ and colistin (p less than 0.05). The duration of severe granulocytopenia and thrombocytopenia did not differ significantly between the two groups (p greater than 0.05).

Citing Articles

Selective Intestinal Decontamination as a Method for Preventing Infectious Complications (Review).

Barsuk A, Nekaeva E, Lovtsova L, Urakov A Sovrem Tekhnologii Med. 2021; 12(6):86-95.

PMID: 34796022 PMC: 8596238. DOI: 10.17691/stm2020.12.6.10.

Prophylactic Measures During Induction for Acute Myeloid Leukemia.

McCarthy M, Walsh T Curr Oncol Rep. 2017; 19(3):18.

PMID: 28251490 DOI: 10.1007/s11912-017-0574-9.

Antibiotic prophylaxis for bacterial infections in afebrile neutropenic patients following chemotherapy.

Gafter-Gvili A, Fraser A, Paul M, Vidal L, Lawrie T, van de Wetering M Cochrane Database Syst Rev. 2012; 1:CD004386.

PMID: 22258955 PMC: 4170789. DOI: 10.1002/14651858.CD004386.pub3.

Use of the quinolones for the prophylaxis and therapy of infections in immunocompromised hosts.

Maschmeyer G Drugs. 1993; 45 Suppl 3:73-80.

PMID: 7689455 DOI: 10.2165/00003495-199300453-00014.

High-dose cytosine arabinoside and daunorubicin postremission therapy in adults with de novo acute myeloid leukemia. Long-term follow-up of a prospective multicenter trial.

Heil G, Mitrou P, Hoelzer D, Freund M, Link H, Ehninger G Ann Hematol. 1995; 71(5):219-25.

PMID: 7492624 DOI: 10.1007/BF01744371.

References

Gale R, Cline M . High remission-induction rate in acute myeloid leukaemia. Lancet. 1977; 1(8010):497-9. DOI: 10.1016/s0140-6736(77)91366-6. View

Watson J, Jameson B, Powles R, McElwain T, Lawson D, Judson I . Co-trimoxazole versus non-absorbable antibiotics in acute leukaemia. Lancet. 1982; 1(8262):6-9. DOI: 10.1016/s0140-6736(82)92554-5. View

Dietrich M, Gaus W, Vossen J, Van Der Waaij D, Wendt F . Protective isolation and antimicrobial decontamination in patients with high susceptibility to infection. A prospective cooperative study of gnotobiotic care in acute leukemia patients. I: clinical results. Infection. 1977; 5(2):107-14. DOI: 10.1007/BF01642091. View

Bow E, Louie T, Riben P, McNaughton R, Harding G, Ronald A . Randomized controlled trial comparing trimethoprim/sulfamethoxazole and trimethoprim for infection prophylaxis in hospitalized granulocytopenic patients. Am J Med. 1984; 76(2):223-33. DOI: 10.1016/0002-9343(84)90777-0. View

Dekker A, Rozenberg-Arska M, Sixma J, Verhoef J . Prevention of infection by trimethoprim-sulfamethoxazole plus amphotericin B in patients with acute nonlymphocytic leukaemia. Ann Intern Med. 1981; 95(5):555-9. DOI: 10.7326/0003-4819-95-5-555. View

. E.O.R.T.C. Gnotobiotic Project Group: a prospective cooperative study of antimicrobial decontamination in granulocytopenic patients. Comparison of two different methods. Infection. 1982; 10(3):131-8. DOI: 10.1007/BF01640762. View

Gualtieri R, Donowitz G, Kaiser D, Hess C, Sande M . Double-blind randomized study of prophylactic trimethoprim/sulfamethoxazole in granulocytopenic patients with hematologic malignancies. Am J Med. 1983; 74(6):934-40. DOI: 10.1016/0002-9343(83)90785-4. View

YATES J, HOLLAND J . A controlled study of isolation and endogenous microbial suppression in acute myelocytic leukemia patients. Cancer. 1973; 32(6):1490-8. DOI: 10.1002/1097-0142(197312)32:6<1490::aid-cncr2820320628>3.0.co;2-6. View

Kurrle E, Bhaduri S, Krieger D, Pflieger H, Heimpel H . Antimicrobial prophylaxis in acute leukaemia: prospective randomized study comparing two methods of selective decontamination. Klin Wochenschr. 1983; 61(14):691-8. DOI: 10.1007/BF01487614. View

10.

Guiot H, van den Broek P, van der Meer J, Van Furth R . Selective antimicrobial modulation of the intestinal flora of patients with acute nonlymphocytic leukemia: a double-blind, placebo-controlled study. J Infect Dis. 1983; 147(4):615-23. DOI: 10.1093/infdis/147.4.615. View

11.

Sleijfer D, Mulder N, de Vries-Hospers H, Fidler V, NIEWEG H, Van Der Waaij D . Infection prevention in granulocytopenic patients by selective decontamination of the digestive tract. Eur J Cancer (1965). 1980; 16(6):859-69. DOI: 10.1016/0014-2964(80)90140-1. View

12.

Levine A, Siegel S, Schreiber A, Hauser J, Preisler H, Goldstein I . Protected environments and prophylactic antibiotics. A prospective controlled study of their utility in the therapy of acute leukemia. N Engl J Med. 1973; 288(10):477-83. DOI: 10.1056/NEJM197303082881001. View

13.

Henry S, Armstrong D, Kempin S, Gee T, Arlin Z, Clarkson B . Oral trimethoprim/sulfamethoxazole in attempt to prevent infection after induction chemotherapy for acute leukemia. Am J Med. 1984; 77(4):663-6. DOI: 10.1016/0002-9343(84)90359-0. View

14.

. Trimethoprim-sulfamethoxazole in the prevention of infection in neutropenic patients. EORTC International Antimicrobial Therapy Project Group. J Infect Dis. 1984; 150(3):372-9. DOI: 10.1093/infdis/150.3.372. View

15.

Rozenberg-Arska M, Dekker A, Verhoef J . Colistin and trimethoprim-sulfamethoxazole for the prevention of infection in patients with acute non-lymphocytic leukaemia. Decrease in the emergence of resistant bacteria. Infection. 1983; 11(3):167-9. DOI: 10.1007/BF01641298. View

16.

Hughes W, Kuhn S, Chaudhary S, Feldman S, Verzosa M, AUR R . Successful chemoprophylaxis for Pneumocystis carinii pneumonitis. N Engl J Med. 1977; 297(26):1419-26. DOI: 10.1056/NEJM197712292972602. View

17.

Granena A, Rozman C . Evaluation of a protective environment in the management of granulocytopenic patients: a comparative study. Cancer. 1981; 48(2):419-24. DOI: 10.1002/1097-0142(19810715)48:2<419::aid-cncr2820480234>3.0.co;2-5. View

18.

Schimpff S, Greene W, YOUNG V, Fortner C, Cusack N, Block J . Infection prevention in acute nonlymphocytic leukemia. Laminar air flow room reverse isolation with oral, nonabsorbable antibiotic prophylaxis. Ann Intern Med. 1975; 82(3):351-8. DOI: 10.7326/0003-4819-82-3-351. View

19.

Estey E, Maksymiuk A, Smith T, Fainstein V, Keating M, McCredie K . Infection prophylaxis in acute leukemia. Comparative effectiveness of sulfamethoxazole and trimethoprim, ketoconazole, and a combination of the two. Arch Intern Med. 1984; 144(8):1562-8. DOI: 10.1001/archinte.144.8.1562. View

20.

Kauffman C, Liepman M, Bergman A, Mioduszewski J . Trimethoprim/sulfamethoxazole prophylaxis in neutropenic patients. Reduction of infections and effect on bacterial and fungal flora. Am J Med. 1983; 74(4):599-607. DOI: 10.1016/0002-9343(83)91017-3. View