Use of trimethoprim-sulfamethoxazole to prevent bacterial infections in children with acute lymphoblastic leukemia
We assessed the efficacy of prophylactic antibiotics in children receiving intensive chemotherapy for acute lymphoblastic leukemia. The patients were randomized to receive either trimethoprim-sulfamethoxazole (TMP-SMX) or placebo in a double-blind trial. Thirty patients were evaluated in each group....
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| Veröffentlicht in: | Pediatric infectious disease 1985-05, Vol.4 (3), p.265-269 |
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| container_title | Pediatric infectious disease |
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| creator | GOORIN, A. M HERSHEY, B. J LEVIN, M. J SIBER, G. R GELBER, R. D FLYNN, K LEW, M BECKETT, K BLANDING, P SALLAN, S. E |
| description | We assessed the efficacy of prophylactic antibiotics in children receiving intensive chemotherapy for acute lymphoblastic leukemia. The patients were randomized to receive either trimethoprim-sulfamethoxazole (TMP-SMX) or placebo in a double-blind trial. Thirty patients were evaluated in each group. Children receiving TMP-SMX had fewer episodes of bacteremia (0 vs. 5) and otitis media (3 vs. 18). The geometric mean of the neutrophil nadir was 172 in the TMP-SMX group and 287 in controls. However, no increased delay or dose reduction of chemotherapy was observed in the TMP-SMX treated patients. Five patients who received TMP-SMX developed Gram-negative rods resistant to TMP-SMX on surveillance stool cultures. We conclude that TMP-SMX prophylaxis decreased certain bacterial infections in children with acute lymphoblastic leukemia without causing clinically significant toxicity. The emergence of Gram-negative rods resistant to TMP-SMX in treated patients suggests that TMP-SMX prophylaxis should be restricted to patients who are at high risk for developing a bacterial infection or Pneumocystis carinii pneumonia. |
| doi_str_mv | 10.1097/00006454-198505000-00012 |
| format | Article |
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M ; HERSHEY, B. J ; LEVIN, M. J ; SIBER, G. R ; GELBER, R. D ; FLYNN, K ; LEW, M ; BECKETT, K ; BLANDING, P ; SALLAN, S. E</creator><creatorcontrib>GOORIN, A. M ; HERSHEY, B. J ; LEVIN, M. J ; SIBER, G. R ; GELBER, R. D ; FLYNN, K ; LEW, M ; BECKETT, K ; BLANDING, P ; SALLAN, S. E</creatorcontrib><description>We assessed the efficacy of prophylactic antibiotics in children receiving intensive chemotherapy for acute lymphoblastic leukemia. The patients were randomized to receive either trimethoprim-sulfamethoxazole (TMP-SMX) or placebo in a double-blind trial. Thirty patients were evaluated in each group. Children receiving TMP-SMX had fewer episodes of bacteremia (0 vs. 5) and otitis media (3 vs. 18). The geometric mean of the neutrophil nadir was 172 in the TMP-SMX group and 287 in controls. However, no increased delay or dose reduction of chemotherapy was observed in the TMP-SMX treated patients. Five patients who received TMP-SMX developed Gram-negative rods resistant to TMP-SMX on surveillance stool cultures. We conclude that TMP-SMX prophylaxis decreased certain bacterial infections in children with acute lymphoblastic leukemia without causing clinically significant toxicity. The emergence of Gram-negative rods resistant to TMP-SMX in treated patients suggests that TMP-SMX prophylaxis should be restricted to patients who are at high risk for developing a bacterial infection or Pneumocystis carinii pneumonia.</description><identifier>ISSN: 0277-9730</identifier><identifier>ISSN: 0891-3668</identifier><identifier>EISSN: 2331-3110</identifier><identifier>DOI: 10.1097/00006454-198505000-00012</identifier><identifier>PMID: 3889875</identifier><language>eng</language><publisher>Baltimore, MD: Williams & Wilkins</publisher><subject>Administration, Oral ; Adolescent ; Antibacterial agents ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Bacterial Infections - etiology ; Bacterial Infections - prevention & control ; Biological and medical sciences ; Child ; Child, Preschool ; Clinical Trials as Topic ; Double-Blind Method ; Drug Combinations - administration & dosage ; Drug Combinations - therapeutic use ; Female ; Humans ; Infant ; Leukemia, Lymphoid - complications ; Male ; Medical sciences ; Pharmacology. Drug treatments ; Random Allocation ; Sulfamethoxazole - administration & dosage ; Sulfamethoxazole - therapeutic use ; Suspensions ; Trimethoprim - administration & dosage ; Trimethoprim - therapeutic use ; Trimethoprim, Sulfamethoxazole Drug Combination</subject><ispartof>Pediatric infectious disease, 1985-05, Vol.4 (3), p.265-269</ispartof><rights>1986 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c339t-7f718f2d996aa9ae21f96e01eacae8cba151b12e439fbf72e7995c42cf6f67e03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27931,27932</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=8423558$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3889875$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GOORIN, A. M</creatorcontrib><creatorcontrib>HERSHEY, B. J</creatorcontrib><creatorcontrib>LEVIN, M. J</creatorcontrib><creatorcontrib>SIBER, G. R</creatorcontrib><creatorcontrib>GELBER, R. D</creatorcontrib><creatorcontrib>FLYNN, K</creatorcontrib><creatorcontrib>LEW, M</creatorcontrib><creatorcontrib>BECKETT, K</creatorcontrib><creatorcontrib>BLANDING, P</creatorcontrib><creatorcontrib>SALLAN, S. E</creatorcontrib><title>Use of trimethoprim-sulfamethoxazole to prevent bacterial infections in children with acute lymphoblastic leukemia</title><title>Pediatric infectious disease</title><addtitle>Pediatr Infect Dis</addtitle><description>We assessed the efficacy of prophylactic antibiotics in children receiving intensive chemotherapy for acute lymphoblastic leukemia. The patients were randomized to receive either trimethoprim-sulfamethoxazole (TMP-SMX) or placebo in a double-blind trial. Thirty patients were evaluated in each group. Children receiving TMP-SMX had fewer episodes of bacteremia (0 vs. 5) and otitis media (3 vs. 18). The geometric mean of the neutrophil nadir was 172 in the TMP-SMX group and 287 in controls. However, no increased delay or dose reduction of chemotherapy was observed in the TMP-SMX treated patients. Five patients who received TMP-SMX developed Gram-negative rods resistant to TMP-SMX on surveillance stool cultures. We conclude that TMP-SMX prophylaxis decreased certain bacterial infections in children with acute lymphoblastic leukemia without causing clinically significant toxicity. The emergence of Gram-negative rods resistant to TMP-SMX in treated patients suggests that TMP-SMX prophylaxis should be restricted to patients who are at high risk for developing a bacterial infection or Pneumocystis carinii pneumonia.</description><subject>Administration, Oral</subject><subject>Adolescent</subject><subject>Antibacterial agents</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Bacterial Infections - etiology</subject><subject>Bacterial Infections - prevention & control</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical Trials as Topic</subject><subject>Double-Blind Method</subject><subject>Drug Combinations - administration & dosage</subject><subject>Drug Combinations - therapeutic use</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Leukemia, Lymphoid - complications</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Pharmacology. 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E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of trimethoprim-sulfamethoxazole to prevent bacterial infections in children with acute lymphoblastic leukemia</atitle><jtitle>Pediatric infectious disease</jtitle><addtitle>Pediatr Infect Dis</addtitle><date>1985-05</date><risdate>1985</risdate><volume>4</volume><issue>3</issue><spage>265</spage><epage>269</epage><pages>265-269</pages><issn>0277-9730</issn><issn>0891-3668</issn><eissn>2331-3110</eissn><abstract>We assessed the efficacy of prophylactic antibiotics in children receiving intensive chemotherapy for acute lymphoblastic leukemia. The patients were randomized to receive either trimethoprim-sulfamethoxazole (TMP-SMX) or placebo in a double-blind trial. Thirty patients were evaluated in each group. Children receiving TMP-SMX had fewer episodes of bacteremia (0 vs. 5) and otitis media (3 vs. 18). The geometric mean of the neutrophil nadir was 172 in the TMP-SMX group and 287 in controls. However, no increased delay or dose reduction of chemotherapy was observed in the TMP-SMX treated patients. Five patients who received TMP-SMX developed Gram-negative rods resistant to TMP-SMX on surveillance stool cultures. We conclude that TMP-SMX prophylaxis decreased certain bacterial infections in children with acute lymphoblastic leukemia without causing clinically significant toxicity. The emergence of Gram-negative rods resistant to TMP-SMX in treated patients suggests that TMP-SMX prophylaxis should be restricted to patients who are at high risk for developing a bacterial infection or Pneumocystis carinii pneumonia.</abstract><cop>Baltimore, MD</cop><pub>Williams & Wilkins</pub><pmid>3889875</pmid><doi>10.1097/00006454-198505000-00012</doi><tpages>5</tpages></addata></record> |
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| ispartof | Pediatric infectious disease, 1985-05, Vol.4 (3), p.265-269 |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Administration, Oral Adolescent Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Bacterial Infections - etiology Bacterial Infections - prevention & control Biological and medical sciences Child Child, Preschool Clinical Trials as Topic Double-Blind Method Drug Combinations - administration & dosage Drug Combinations - therapeutic use Female Humans Infant Leukemia, Lymphoid - complications Male Medical sciences Pharmacology. Drug treatments Random Allocation Sulfamethoxazole - administration & dosage Sulfamethoxazole - therapeutic use Suspensions Trimethoprim - administration & dosage Trimethoprim - therapeutic use Trimethoprim, Sulfamethoxazole Drug Combination |
| title | Use of trimethoprim-sulfamethoxazole to prevent bacterial infections in children with acute lymphoblastic leukemia |
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