Efficacy of selective digestive decontamination in patients with multiple myeloma undergoing high-dose chemotherapy and autologous stem cell transplantation.

Abstract:

:Selective digestive decontamination (SDD) with the oral, non-absorbable antimicrobial substances gentamicin, vancomycin and amphotericin B was optionally used at our institution to reduce the risk of gastrointestinal tract derived infections in multiple myeloma (MM) patients undergoing high-dose chemotherapy with subsequent autologous stem cell transplantation (HDCT/ASCT). The majority of patients received sulfamethoxazole-trimethoprim as pneumocystis pneumonia prophylaxis. From 203 patients receiving their first HDCT/ASCT between 2009 and 2015, we compared retrospectively 90 patients receiving SDD to 113 patients not receiving SDD. The administration of SDD was associated with a reduction of bacterial infections after HDCT/ASCT (overall: 8% versus 24%, p = .002; gram-negative pathogens: 1% versus 11%, p = .006) and less use of systemic antibiotics (62% versus 77%, p = .022). Omission of SDD was an independent risk factor for developing neutropenic fever and bloodstream infections. SDD could be an option to reduce bacterial infections in patients undergoing HDCT/ASCT that needs to be tested in prospective trials.

journal_name

Leuk Lymphoma

journal_title

Leukemia & lymphoma

authors

Mürner CM,Stenner-Liewen F,Seifert B,Mueller NJ,Schmidt A,Renner C,Schanz U,Knuth A,Manz MG,Scharl M,Gerber B,Samaras P

doi

10.1080/10428194.2018.1496332

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

685-695

issue

3

eissn

1042-8194

issn

1029-2403

journal_volume

60

pub_type

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