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Prophylactic co-trimoxazole and lactobacilli preparation in neutropenic patients
Insights
Co-trimoxazole and lactobacilli preparations offer better tolerance and quality of life for children with neutropenia during cancer treatment. This study found no significant difference in infection rates or recovery time compared to other decontamination methods.
Area of Science:
- Pediatric Oncology
- Infectious Disease Management
- Gastrointestinal Microbiology
Background:
- Neutropenia in pediatric cancer patients increases infection risk.
- Intestinal decontamination is used to prevent infections in neutropenic children.
- Evaluating different decontamination regimens is crucial for patient care.
Purpose of the Study:
- To compare the efficacy and tolerability of two intestinal decontamination regimens in children with leukemia and solid tumors.
- To assess the impact on infection incidence and recovery from neutropenia.
Main Methods:
- A randomized study involving 68 children undergoing chemotherapy.
- Group 1: Framycetin, colymycin, nystatin, and metronidazole.
- Group 2: Co-trimoxazole and lactobacilli preparation.
Main Results:
- No significant difference in infection incidence during neutropenia between groups.
- No significant difference in the time to recover from neutropenia.
- Co-trimoxazole and lactobacilli were significantly better tolerated, with fewer side effects.
Conclusions:
- Co-trimoxazole and lactobacilli improve quality of life during neutropenic episodes.
- These agents are well-tolerated, cost-effective, and comparable in efficacy for infection prevention.
- This regimen is a favorable option for intestinal decontamination in pediatric oncology.
Abstract:
A randomized study of intestinal decontamination was undertaken in 68 children with leukemia and solid tumours. Framycetin, colymycin, nystatin, and metronidazole were given in 35 neutropenic episodes in 33 children, while co-trimoxazole and lactobacilli preparation were administered in 35 episodes in 35 children. The diseases, severity of neutropenia, and incidence of infection at entry into study were comparable in the two groups. There was no significant difference in the incidence of infections developing during the phase of neutropenia. The median and range of time required to recover from neutropenia were also not different. Co-trimoxazole and lactobacilli were significantly better tolerated, there being no nausea and vomiting, no refusal to take medication, no dose reduction or change to an alternative regimen. We conclude that co-trimoxazole and lactobacilli preparation improve quality of life during a neutropenic episode and have the additional advantage of being relatively inexpensive.