Prevention of Bacteremias Caused by α-Hemolytic Streptococci by Roxithromycin in Patients Treated with Intensive Cytotoxic Treatment
Microorganisms that frequently cause infections in patients with severe and prolonged granulocytopenia are endogenous gramnegative bacilli belonging to the normal flora of the alimentary tract . Patients treated with cytotoxic drugs with a high degree of mucosal toxicity such as amsacrine and high-dose cytosine arabinoside or conditioning regimens for bone marrow transplantation are at high risk for bacteremias caused by α-hemolytic streptococci, microorganisms not commonly recognized as opportunistic pathogens [2–5]. We have shown that ciprofloxacin is highly effective in prevention of infection as well as colonization by gram-negative bacilli in granulocytopenic patients [6, 7]. However, infections caused by gram-positive bacteria, especially a-hemolytic streptococci and Staphylococcus epidermidis (often associated with the presence of indwelling catheters), have remained a problem. In the present study we added oral roxithromycin , a well-absorbed macrolide, to our prophylactic regimen during the granulocytopenic days with the highest degree of mucosal damage.
KeywordsAcute Leukemia Alimentary Tract Adult Respiratory Distress Syndrome Autologous Bone Marrow Transplantation Prophylactic Regimen
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