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Fungal colonization and invasive fungal infections following allogeneic BMT using metronidazole, ciprofloxacin and fluconazole or ciprofloxacin and fluconazole as intestinal decontamination.
Bone Marrow Transplant. 2000 Nov; 26(9):993-7.BM

Abstract

Invasive fungal infections (IFI) are increasingly diagnosed in patients undergoing allogeneic BMT. We have previously shown that the addition of metronidazole to ciprofloxacin for gastrointestinal bacterial decontamination significantly reduces the incidence of grades II-IV aGVHD by reduction of the anaerobic intestinal bacterial flora. Here, we found that the combined use of ciprofloxacin, metronidazole and fluconazole as antifungal prophylaxis increased intestinal yeast colonization when compared to ciprofloxacin and fluconazole alone (P < 0.01). Based on the EORTC criteria, a total of 18 out of 134 study patients developed IFI: seven of 68 (10%) patients who received metronidazole compared to 11 of the 66 (17%) patients decontaminated without metronidazole developed IFI (log-rank P = 0.36). Lethal IFI occurred in two of seven patients receiving metronidazole and in four of 11 patients without anaerobic decontamination. In conclusion, bacterial intestinal decontamination using metronidazole as an antibiotic with activity against most anaerobic intestinal bacteria significantly increases the intestinal yeast burden without influencing the incidence of IFI in patients undergoing allogeneic BMT.

Authors+Show Affiliations

Department of Bone Marrow Transplantation, University Hospital Essen, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11100279

Citation

Trenschel, R, et al. "Fungal Colonization and Invasive Fungal Infections Following Allogeneic BMT Using Metronidazole, Ciprofloxacin and Fluconazole or Ciprofloxacin and Fluconazole as Intestinal Decontamination." Bone Marrow Transplantation, vol. 26, no. 9, 2000, pp. 993-7.
Trenschel R, Peceny R, Runde V, et al. Fungal colonization and invasive fungal infections following allogeneic BMT using metronidazole, ciprofloxacin and fluconazole or ciprofloxacin and fluconazole as intestinal decontamination. Bone Marrow Transplant. 2000;26(9):993-7.
Trenschel, R., Peceny, R., Runde, V., Elmaagacli, A., Dermoumi, H., Heintschel von Heinegg, E., Müller, K. D., Schaefer, U. W., & Beelen, D. W. (2000). Fungal colonization and invasive fungal infections following allogeneic BMT using metronidazole, ciprofloxacin and fluconazole or ciprofloxacin and fluconazole as intestinal decontamination. Bone Marrow Transplantation, 26(9), 993-7.
Trenschel R, et al. Fungal Colonization and Invasive Fungal Infections Following Allogeneic BMT Using Metronidazole, Ciprofloxacin and Fluconazole or Ciprofloxacin and Fluconazole as Intestinal Decontamination. Bone Marrow Transplant. 2000;26(9):993-7. PubMed PMID: 11100279.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fungal colonization and invasive fungal infections following allogeneic BMT using metronidazole, ciprofloxacin and fluconazole or ciprofloxacin and fluconazole as intestinal decontamination. AU - Trenschel,R, AU - Peceny,R, AU - Runde,V, AU - Elmaagacli,A, AU - Dermoumi,H, AU - Heintschel von Heinegg,E, AU - Müller,K D, AU - Schaefer,U W, AU - Beelen,D W, PY - 2000/12/2/pubmed PY - 2001/3/10/medline PY - 2000/12/2/entrez SP - 993 EP - 7 JF - Bone marrow transplantation JO - Bone Marrow Transplant. VL - 26 IS - 9 N2 - Invasive fungal infections (IFI) are increasingly diagnosed in patients undergoing allogeneic BMT. We have previously shown that the addition of metronidazole to ciprofloxacin for gastrointestinal bacterial decontamination significantly reduces the incidence of grades II-IV aGVHD by reduction of the anaerobic intestinal bacterial flora. Here, we found that the combined use of ciprofloxacin, metronidazole and fluconazole as antifungal prophylaxis increased intestinal yeast colonization when compared to ciprofloxacin and fluconazole alone (P < 0.01). Based on the EORTC criteria, a total of 18 out of 134 study patients developed IFI: seven of 68 (10%) patients who received metronidazole compared to 11 of the 66 (17%) patients decontaminated without metronidazole developed IFI (log-rank P = 0.36). Lethal IFI occurred in two of seven patients receiving metronidazole and in four of 11 patients without anaerobic decontamination. In conclusion, bacterial intestinal decontamination using metronidazole as an antibiotic with activity against most anaerobic intestinal bacteria significantly increases the intestinal yeast burden without influencing the incidence of IFI in patients undergoing allogeneic BMT. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/11100279/Fungal_colonization_and_invasive_fungal_infections_following_allogeneic_BMT_using_metronidazole_ciprofloxacin_and_fluconazole_or_ciprofloxacin_and_fluconazole_as_intestinal_decontamination_ L2 - http://dx.doi.org/10.1038/sj.bmt.1702655 DB - PRIME DP - Unbound Medicine ER -