Efficacy of selective digestive decontamination in patients with multiple myeloma undergoing high-dose chemotherapy and autologous stem cell transplantation. Issue 3 (23rd February 2019)

• Record Type: Journal Article
• Authors: Mürner, Céline M.; Stenner-Liewen, Frank; Seifert, Burkhardt; Mueller, Nicolas J.; Schmidt, Adrian; Renner, Christoph; Schanz, Urs; Knuth, Alexander; Manz, Markus G.; Scharl, Michael; Gerber, Bernhard; Samaras, Panagiotis
• Is Part Of: Leukemia & lymphoma. Volume 60:Issue 3(2019)
• Page Start: 685
• Page End: 695
• Publication Date: 2019-02-23
• Subjects: Infectious complications -- myeloma -- autologous stem cell transplantation -- selective digestive decontamination -- antibiotic resistance -- neutropenic fever; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2018.1496332
• Languages: English
• ISSNs: 1042-8194

Abstract

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.