INFECTIOUS COMPLICATIONS IN PATIENTS UNDERGOING MARROW TRANSPLANTATION - A PROSPECTIVE RANDOMIZED STUDY OF THE ADDITIONAL EFFECT OF DECONTAMINATION AND LAMINAR AIR-FLOW ISOLATION AMONG PATIENTS RECEIVING PROPHYLACTIC SYSTEMIC ANTIBIOTICS
INFECTIOUS COMPLICATIONS IN PATIENTS UNDERGOING MARROW TRANSPLANTATION - A PROSPECTIVE RANDOMIZED STUDY OF THE ADDITIONAL EFFECT OF DECONTAMINATION AND LAMINAR AIR-FLOW ISOLATION AMONG PATIENTS RECEIVING PROPHYLACTIC SYSTEMIC ANTIBIOTICS
复制标题
DOI：
10.3109/00365548709032423
复制
发表时间：
1987-01-01
影响因子：
--
通讯作者：
THOMAS, ED
中科院分区：
文献类型：
--
作者：
PETERSEN, FB;BUCKNER, CD;THOMAS, ED
99例恶性血液病患者接受了来自hla相同的兄弟姐妹供体的同种异体骨髓移植，并随机接受两种感染预防方式中的一种，同时粒细胞减少：(1)在常规病房预防性全身抗生素治疗（PSA， 50例）或(2)在层流病房去污、隔离并给予预防性全身抗生素治疗（LAF + PSA， 49例）。LAF + PSA组只有1例（3%）患者出现败血症，同时粒细胞减少，而PSA组有11例（24%）患者出现败血症（p < 0.005）。LAF + PSA组有3例（6%）患者出现严重局部感染，而PSA组有9例（18%）患者出现严重局部感染（p = 0.06）。移植后住院天数、粒细胞减少天数、发热天数、急性移植物抗宿主病发生率、间质性肺炎发生率或总生存期均无显著差异。我们的结论是，在骨髓移植患者的去污和层流气流隔离中使用预防性全身抗生素可显著降低粒细胞减少期败血症的发生率。
99 patients with hematological malignancies underwent allogenic marrow transplantation from HLA-identical sibling donors and were randomized to receive one of two forms of infection prophylaxis while granulocytopenic: (1) prophylactic systemic antibiotics in a conventional hospital room (PSA, 50 patients) or (2) decontamination, isolation in a laminar air flow room and the administration of prophylactic systemic antibiotics (LAF + PSA, 49 patients). Only 1 patient (3%) in the LAF + PSA group acquired septicemia while granulocytopenic compared to 11 (24%) patients in the PSA group (p < 0.005). Three patients (6%) in the LAF + PSA group acquired major localized infections compared to 9 (18%) in the PSA group (p = 0.06). There was no significant difference in days in hospital post transplant, days of granulocytopenia, days of fever, incidence of acute graft-versus-host disease, interstitial pneumonitis or overall survival. We conclude that the use of prophylactic systemic antibiotics added to decontamination and laminar air flow isolation of patients undergoing marrow transplantation significantly reduces the incidence of septicemia in the granulocytopenic period.