Colistin and trimethoprim-sulfamethoxazole for the prevention of infection in patients with acute non-lymphocytic leukaemia. Decrease in the emergence of resistant bacteria.

Abstract:

:In a previous study we demonstrated that trimethoprim-sulfamethoxazole decreases the prevalence of infection in patients with severe granulocytopenia. However, treatment was accompanied by a relatively high incidence of multiresistant microorganisms. We therefore conducted this study to determine whether the addition of colistin to the trimethoprim-sulfamethoxazole regimen prevents the emergence of these resistant bacteria. Thirty consecutive adult patients with acute non-lymphocytic leukaemia received trimethoprim-sulfamethoxazole plus colistin p.o. prophylactically. The results of this study were compared with the results of our previously published controlled study. Trimethoprim-sulfamethoxazole plus colistin was as effective as trimethoprim-sulfamethoxazole in preventing infection. However, the addition of colistin significantly reduced the acquisition of and infection by gram-negative bacilli which were resistant to trimethoprim-sulfamethoxazole. Only two patients were colonized with resistant strains, and no infections with these strains were observed. We have concluded that patients with acute non-lymphocytic leukaemia should receive a combination of trimethoprim-sulfamethoxazole plus colistin prophylactically during remission induction treatment.

journal_name

Infection

journal_title

Infection

authors

Rozenberg-Arska M,Dekker AW,Verhoef J

doi

10.1007/BF01641298

subject

Has Abstract

pub_date

1983-05-01 00:00:00

pages

167-9

issue

3

eissn

0300-8126

issn

1439-0973

journal_volume

11

pub_type

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