A Trial of Infection Prevention in Autologous Bone Marrow Transplants by Selective Intestinal Decontamination

TESHIMA Hirofumi, FUNADA Hisashi, HATTORI Ken-ichi

doi:10.11150/kansenshogakuzasshi1970.58.417

In an attempt to prevent infections complicating bone marrow transplantation, selective intestinal decontamination was carried out in 3 patients. The antibiotic regimen consisted of oral gentamicin (960 mg/day) and amphotericin B (800-1600 mg/day) (GA).<BR>Aerobic gram-negative bacilli initially cultured from the feces were completely suppressed within one week after initiation of antibiotic prophylaxis. On the other hand, the number of anaerobic bacteria remained unchanged during GA administration. In 2 patients GA administration extended over a period of 8 weeks. In one patient aerobic gram-negative bacilli were not isolated during antibiotic prophylaxis. In the other patient, gentamicin-resistant Klebsiella pneumoniae appeared when fecal anaerobic flora was completely suppressed by intravenous cefmetazole administration. Candida persisted in 2 patients despite the prophylaxis. The suppression pattern of the throat flora after initiation of the oral antibiotics was similar to that observed in the stool. Diarrhea, weight loss and hypocholesterolemia were noted during the prophylaxis. Nausea and vomiting were often associated with the radio-chemotherapy. During antibiotic prophylaxis enterococcal septicemia developed in one patient. This organism persisted in the patient's own stool during the antibiotic prophylaxis.<BR>Therefore, GA is thought to produce satisfactory suppression of intestinal aerobic gram-negative bacilli and deserve further study.

A Trial of Infection Prevention in Autologous Bone Marrow Transplants by Selective Intestinal Decontamination

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