���\����f�����؂��>X��~eŽ��t�Z�IQ�G `���0#���F꺝//��#t[�h4�k:�� 3b�oV���=�W�0���׳:��"°)G�a�_�st�afO3�l�=��W�3�-���Tx7�k��O�a�?����xN���}h�W)>`��/�!�>ŢD��1�V� 3t[>1iV��?e1�v.� ������"��~����6u�̞f��%mq�������O�I�`����S"M�˥�j#�N������o3�:�E�;��G$�6��M8���8�����)�&Hb,�t0r��V�WDl�dҢ?1B`�0C�+��ogƀ��sp�cJ�`&���&�w�g#���nݺA1eud�3���Uq(�.�1�޾o�B7��5���g:i�7�K`�3AM٪�R�o�l����fƀ�޽�y���ߜ�؂R�4��i�}Bd��`f�OW��f����q�I$,�UGٲ�&�j�u���V>}�q��`F�Tq�_n�˟��3>�F`&�eƀ�OӬcNzlA)]�̍4q�;�-`f����3�G�O� K�#�!O'�h���ޫ��?F�z��/�$. Use of quinolones reduces the incidence of gram-negative bacillary infections but increases the frequency of infections caused by streptococci and staphylococci before marrow engraftment. <> Articles on the use of antimicrobial agents for the prevention of infections in bone marrow transplant recipients and neutropenic patients with cancer. 2 0 obj

Available antimicrobial agents can prevent common bacterial, viral, and “early” fungal infections. A bone marrow transplant is also called a stem cell transplant.

A meta-analysis of randomized controlled trials. stream ���f��w��P7�З�ߏ�.��w�f��. Optimal chemoprophylaxis is not available against aspergillus or fungal infections that develop after engraftment. f§fS�E��#����0��fT��� ���؂R�4� S#MbE)Ǭ���M��Q��8#���Q��?� ��fM|�7m����n��ͥcL�R`�i��Y��e���>f�Q�����c�{lA)] �̊4egPl3㯪g��aaF}t����4���}=8@Qj4�D�� f¼H��1�K��-^ ]�>��������@�1�^ However, the few studies that address antimicrobial prophylaxis in bone marrow transplantation have not always shown a survival benefit. <> One trial compared two different systemic antibiotic regimens: fluoroquinolones versus trimethoprim-sulfamethoxazole. High-dose acyclovir may suppress reactivation of cytomegalovirus. endobj Oral ciprofloxacin as antibacterial prophylaxis after allogeneic bone marrow transplantation: A reappraisal January 2000 Bone Marrow Transplantation 24(11):1207-11 However, the few studies that address antimicrobial prophylaxis in bone marrow transplantation have not always shown a survival benefit. 7 0 obj 18 UK Bone Marrow Transplant Teams. Toxicity and cost-effectiveness of prophylactic strategies should be critically evaluated. Seventeen trials with 1453 autologous and allogeneic HSCT recipients were included.

endobj Systemic antibiotic prophylaxis was compared with placebo or no prophylaxis in 10 trials and with non-absorbable antibiotics in two trials. <> Systemic antibiotics other than fluoroquinolones were evaluated in five of these 12 trials. INFECTION PROPHYLAXIS AND TREATMENT FOR ADULT AND PEDIATRIC BONE MARROW TRANSPLANT RECIPIENTS Page 1 of 9 I. Sheridan JF, Tutschka PJ, Sedmak DD, Copelan EA. III. We performed a meta-analysis to evaluate the impact of systemic antibiotic prophylaxis in hematopoietic stem cell transplantation (HSCT) recipients. Available antimicrobial agents can prevent common bacterial, viral, and “early” fungal infections. The decrease of this complication observed after the beginning of the prophylaxis programme was statistically significant. <>

BackgroundPatients immediately post-hematopoietic cell transplantation are at high risk for bacteremia. Hoyle C, Goldman JM. A randomized prospective study comparing oral broad-spectrum nonabsorbable antibiotics (vancomycin-tobramycin-colistin) to absorbable antibiotics (ofloxacin-amoxicillin) All Rights Reserved. Different strategies have been developed to reduce the risk for CMV-associated sickness and death, including the blood transfusion policy,1 prophylaxis with high-dose intravenous (IV) immunoglobulin,2 high-dose acyclovir (2-amino-1,9-dihydro-9-[(2-hydroxy … Acyclovir prevents herpes simplex virus infection, but its prolonged use to prevent reactivation of varicella-zoster virus is not cost-effective and remains controversial.

Patients undergoing bone marrow transplantation (BMT) are at risk for granulocytopenia, impairment of barrier defenses, and impairment of cell-mediated immunity (CMI) and humoral immunity. To review the efficacy of antimicrobial prophylaxis in bone marrow transplantation. stream English-language articles identified through a MEDLINE search (1975 to 1994) and through the bibliographies of selected articles. Copyright © 2020 Elsevier B.V. or its licensors or contributors. 9 0 obj We use cookies to help provide and enhance our service and tailor content and ads. endobj We collected reports from PubMed, the Cochrane Library, EMBASE, CINAHL, and Web of Science, along with references cited therein. <> �؉�UgA������Ǥݧn��-O��J#�e�0�M�h�{߳#����}���af3�n�y���&Ϝ�؂�z���^ ����QƔ�֨ﲇjO3T�ȥ�Z��u�2̵���g�Cl��o�y����(�?m31��o ��xvd�ٗ���ވRUe�q�����f(=��J��[p]0s;5Ҕ�n1���SG�d(�j����b��f�c2�)��2N�]q��G���Z��1�8��!�ޖ����R��3��)��ģ!�3�`�J����4���f�\t�@���0����������v0�p����jf2�\�,�����0C}�赪�a�0�ѫfDW�f�O��KY���ۍ �����)��o+��H�1��,��*���Y��u"[+"�"��`� Acknowledgment: The authors thank Ms. Eileen Surma for expert secretarial assistance. This impairment leads to an immunocompromised state, allowing microorganisms to cause infection more easily, even those with limited pathogenicity. Copyright © 2020 American College of Physicians. By continuing you agree to the use of cookies. endobj Immunoglobulin G subclass deficiency and pneumococcal infection after allogeneic bone marrow transplantation. 15 0 obj