Antimicrobial chemoprophylaxis in immunocompromised patients

Opportunistic infections cause considerable morbidity and mortality in immunocompromised patients. Therefore, high priority should be given to efforts of prevention of infectious complications in these patients. Antimicrobial chemoprophylaxis is an important part of the preventive strategies used. Regimens for chemoprophylaxis are available against bacteria, protozoa, fungi and viruses. Important candidates for prophylaxis are patients with severe neutropenia, patients receiving bone-marrow or organ transplants, and patients with AIDS. While often effective, antimicrobial prophylaxis may be associated with problems. Thus, potential side effects may be serious. Emergence of resistant microbes may occur. The compliance may be poor for some prophylactic regimens. The disadvantages, including the cost of any particular regimen, should be balanced against the benefits obtained. However, the principle of antimicrobial prophylaxis remains attractive, and improved regimens will become available in the near future.