Infection prevention in autologous bone marrow transplantation and the role of protective isolation.
The efficacy of an antimicrobial regimen for prevention of infections was prospectively evaluated in 113 patients undergoing autologous bone marrow transplantation (BMT). Ciprofloxacin, 500 mg orally twice a day plus antifungal prophylaxis, fluconazole 50 mg once daily plus amphotericin B tablets or suspension and tablets, each 200 mg four times a day, was given. In addition all patients received streptococcal prophylaxis for 10 days after BMT. Documented infections occurred in 39% (44 of 113) of patients and unexplained fever in 27% (30 of 113). The efficacy of this regimen was reflected in a low mortality rate (3.5%) from infections and in the low need for intravenous amphotericin B (7%). No benefit of protective isolation was found in 59 patients compared with 54 patients treated without isolation measures.
Department of Haematology, University Hospital Utrecht, The Netherlands.
A W
AW
Dekker
L F
LF
Verdonck
M
M
Rozenberg-Arska
D000293:Adolescent; D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods*; D002939:Ciprofloxacin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology / Q000517:prevention & control*; D010356:Patient Isolation; D011446:Prospective Studies; D014182:Transplantation, Autologous
D002939:Ciprofloxacin; D000666:Amphotericin B; D015725:Fluconazole