Msdlatinamerica.com

N
Study Design
Intervention
Fever: 18.1% TMP-SMZ / E vs 32.2% PL; p ϭ .009 Infection: 3.8% TMP-SMZ / E vs 11.9% PL; p ϭ 0.37 Time to infection: 17 days TMP-SMZ / N vs 8 days NL / N; Duration of granulocytopenia: 23.6 days TMP-SMZ / N vs NL / N; p ϭ .007Deaths: 7 TMP-SMZ / N vs 3 NL/NGram negative bacilli: greater acquisition in NL / N; Infection: 64/185 (35%) PL vs 46/177 (26%) TMP-SMZ; BSI: 32/165 (19%) PL vs 22/177 (12%) TMP-SMZ; C: Decreased colonization with gram-negative bacilli Time to fever: 6.3 days NF vs 3.7 days PL; p ϭ .005 No effect on fungi or gram-positive infections GP infections: 11/30 PL vs 0/30 V; p ϭ .002 Deaths: 1 PL vs 0 VV decreased fever and empiric antibiotics Resistant bacteria: 5/ 22 O/A vs 2/22 V/T/C Duration of fever: 9.2 days O/A vs 13.7 days V/T/C; before transplant to 15 daysafter neutropenia resolved 14 patients with proven bacterial infection Fever: 190/268 (71%) PV vs 213/268 (79%) PL / PF; BSI: 38/268 (14%) PV vs 58/268 (22%) PL / PF; p ϭ .03 Streptococcal BSI: 14/268 (5%) PV vs 27/268 (10%) PL / PF No difference in fever, duration of neutropenia or C. difficile enterocolitis: O C vs 10 TMP-SMZ; p ϭ .001 Fever: no difference between the two groups C/R did not reduce significantly gram-positive C/R higher incidence of drug-related side effects; N
Study Design
Intervention
Clinical response 91/103 (88%) S/C vs I 84/104 (81%) 1; 42/166 (25%) on NF developed gram-positive infections vs. 2/37 (5.4%) without prophylactic NF; p ϭ .007 Diarrhea 31/103 (30%) S/C vs 1 15/102 (15%); p ϭ .007 Acute GVHD grades II–IV: C/M 22% vs C 54%; p Ͻ .001 Fecal samples without anaerobic growth: CM 53% vs C Fecal anaerobes in acute GVHD grades II–IV is 100-fold higher than in acute GVHD grades 0–1; p Ͻ .005 Fluoroquinolone-resistant E. coli (MIC—8 to 64 mg/L) in Mean number of days of prophylaxis greater in those Invasive fungal infections 7/68 (10%) M/C/F vs 11/66 Anaerobic growth in fecal samples: 236/446 (53%) M/C/F Yeast growth in fecal samples: 334/446 (75%) M/C/F vs C/Col lower proportion of neutropenic febrile days; C/Col lower proportion of neutropenic antibiotic days; Total bacterial isolates 16/64 C/Col vs 44/64 N/Col; S. aureus 0/64 C/Col vs 10/64 N/Col; p ϭ .001Total gram-positive 14/64 C/Col vs 25/64 N/Col; p ϭ .03Total gram-negative 2/64 C/Col vs 16/64 N/Col; p Ͻ .001 BMT, bone marrow transplant recipients; TMP-SMZ, trimethoprim-sulfamethoxazole; N, nystatin; GENT, gentamicin/nystatin; BSI, bloodstream infection; E, erythromycin; PL, placebo; NL/NY, nalidixic acid/nystatin; C, ciprofloxacin; CH, chlorhexidine; GNB, gram-negative bacilli; NF, norfloxacin; V, vancomycin;O/A, ofloxacin/amoxicillin; V/T/C, vancomycin/tobramycin/colisitin; C/N, chlorhexidine & nystatin; PV, penicillin V; PF, pefloxacin; PL/PF, placebo & pefloxacin; R, rifampin; I, imipenem; S/C, sulbactam/cefoperazone; C/F, ciprofloxacin/fluconazole; M, metronidiazole; C/Col, ciprofloxacin/colistin; N/Col, neomycin/colistin.

Source: http://www.msdlatinamerica.com/ebooks/HospitalEpidemiologyandInfectionControl/files/19ce459e6107e1bffc7c4ccea9ffdfc4.pdf

lrvc.co.uk

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