Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-15T01:57:11.374Z Has data issue: false hasContentIssue false

Prophylactic non-absorbable antibiotics in leukaemic patients

Published online by Cambridge University Press:  15 May 2009

Kathleen King
Affiliation:
Division of Microbiology, Prince of Wales Hospital, Randwick, Sydney, N.S.W. 2031, Australia
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

A regimen of oral non-absorbable prophylactic antibiotics (kanamycin–vanco–mycin–nystatin) was given to nine severely neutropaenic leukaemic patients on cytotoxic therapy (11 courses), in conjunction with isolation procedures. An appreciable decrease in faecal organisms, especially anaerobes, was apparent after 48 h of commencing the course, and most bacteria had disappeared from the stool after five days. There were three episodes of septicaemia, all with enteric organisms, whilst on these antibiotics; one proved fatal. The emergence of resistance to aminoglycosides in faecal flora, notably Klebsiella, in 6/11 courses constituted a major problem in the use of such prophylaxis.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1980

References

Bell, S. M. (1975). The CDS disc method of antibiotic sensitivity testing. Pathology 7 (suppl.), 1.CrossRefGoogle ScholarPubMed
Bender, J. F., Schimpff, S. C., Young, V. M., Fortner, C. L., Brouillet, M. D., Love, Lillian J. & Wiernik, P. H. (1979). Role of vancomycin as a component of oral non-absorbable antibiotics for microbial suppression in leukaemic patients. Antimicrobial Agents and Chemotherapy 15, 455.Google Scholar
Bodey, G. P., Loftis, J. & Bowen, E. (1968). Protected environment for cancer patients. Archives of Internal Medicine 122, 23.Google Scholar
Bodey, G. P. & Rosenbaum, B. (1974). Effect of prophylactic measures on the microbia flora of patients in protected environment units. Medicine 53, 209.CrossRefGoogle Scholar
Cowan, S. T. & Steel, K. J. (1974). Manual for the identification of Medical Bacteria, 2nd edn. Cambridge University Press.Google Scholar
Ericsson, H. & Sherris, J. C. (1971). Antibiotic sensitivity testing. Acta pathologica et microbiologica scandinavica 217 (suppl.).Google ScholarPubMed
Goldschmidt, M. C. & Bodey, G. P. (1972). Effect of chemotherapeutic agents upon microorganisms isolated from cancer patients. Antimicrobial Agents and Chemotherapy 1, 348.Google Scholar
Gorbach, S., Banwell, J., Chatterjee, B., Jacobs, B. & Sack, R. (1971). Acute undifferentiated human diarrhoea in the tropics. 1. Alterations in intestinal microflora. Journal of Clinical Investigation 50, 881.CrossRefGoogle Scholar
Greene, W. H., Moody, M., Schimpff, S., Young, V. & Wiernik, P. (1973). Pseudomonas aeruginosa resistant to carbenicillin and gentamicin. Epidemiologic and clinical aspects in a cancer centre. Annals of Internal Medicine 79, 684.Google Scholar
Gurwith, M. (1978). Prevention of infection in leukaemia. Journal of Antimicrobial Chemotheraphy 4, 302.CrossRefGoogle ScholarPubMed
Hahn, D. M., Schimpff, S. C., Fortner, C. L., Collier-Smyth, A., Young, V. M. & Wiernik, P. H. (1978). Infection in acute leukaemia patients receiving oral non-absorbable antibiotics. Antimicrobial Agents and Chemotherapy 13, 958.CrossRefGoogle Scholar
King, K. (1979). Septicaemia in patients with haematological malignant disease. (In the Press.)Google Scholar
Klastersky, J., Debusscher, L., Weerts, D. & Daneau, D. (1974). Use of oral antibiotics in protected environment units: clinical effectiveness and role in the emergence of antibiotic resistant strains. Pathologie et Biologie 22, 5.Google ScholarPubMed
Levine, A. S. (1976). Protected environment-prophylactic antibiotic programmes. Clinical Studies in Haematology 5, 409.Google Scholar
Levine, A. S., Robinson, R. A. & Hauser, J. M. (1975). Analysis of studies on protected environments and prophylactic antibiotics in adult acute leukaemia. European Journal of Cancer 11 (suppl.), 57.Google Scholar
Moody, M. R., Morris, M. J., Young, V. M., Moye, L. A., Schimpeff, S. C. & Wiernik, P. H. (1978). Effect of two cancer chemotherapeutic agents on the antibacterial activity of three antimicrobial agents. Antimicrobial Agents and Chemotherapy 14, 737.Google Scholar
Penland, W. Z. & Perry, S. (1970). Portable laminar air flow isolator. Lancet i, 174.CrossRefGoogle Scholar
Preisler, H. D., Goldstein, I. M. & Henderson, E. S. (1970). Gastrointestinal ‘sterilization’ in the treatment of patients with acute leukaemia. Cancer 26, 1076.Google Scholar
Rodriguez, V., Bodey, G. P., Freireich, E. J., McCredie, K. B., Gutteman, J. U., Keating, M. J., Smith, T. L. & Gehan, E. A. (1978). Randomized trial of protected environment-prophylactic antibiotics in 145 adults with acute leukaemia. Medicine 57, 253.Google Scholar
Storring, R. A., McElwain, T. J., Jameson, B., Wiltshaw, E., Spiers, A. S. C. & Gaya, H. (1977). Oral non-absorbed antibiotics prevent infection in acute non-lymphoblastic leukaemia. Lancet ii, 837.CrossRefGoogle Scholar
Watson, J. G. & Jameson, B. (1979). Antibiotic prophylaxis for patients in protective isolation. Lancet i, 1183.CrossRefGoogle Scholar