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Prophylaxis of streptococcal bacteraemia with oral penicillin V in children undergoing bone marrow transplantation
E Castagnola1, E Lanino, A Garaventa
1Department of Infectious Diseases, G. Gaslini Children's Hospital, Genoa, Italy.
Insights
Oral penicillin V prophylaxis significantly reduced streptococcal bacteraemia in pediatric bone marrow transplant patients. This preventative measure is effective in centers with high complication rates.
Area of Science:
- Pediatric Hematology
- Infectious Disease Prevention
- Bone Marrow Transplantation
Background:
- Streptococcal bacteraemia poses a significant risk to pediatric patients undergoing bone marrow transplantation.
- Previous incidence rates of streptococcal bacteraemia were high in this vulnerable population.
- Prophylaxis strategies are crucial to mitigate infectious complications post-transplant.
Purpose of the Study:
- To evaluate the effectiveness of oral penicillin V prophylaxis in reducing streptococcal bacteraemia incidence.
- To compare bacteraemia rates in pediatric bone marrow transplant patients before and after implementing penicillin V prophylaxis.
- To assess the impact of penicillin V on streptococcal bacteraemia in a high-incidence setting.
Main Methods:
- Retrospective analysis of pediatric bone marrow transplant patients from January 1991 to December 1993 receiving oral penicillin V prophylaxis.
- Comparison of data with a historical cohort (September 1984 to July 1990) that did not receive penicillin V prophylaxis.
- Statistical analysis to determine the significance of the observed decrease in streptococcal bacteraemia.
Main Results:
- The incidence of streptococcal bacteraemia decreased from 71% (historical cohort) to 41% (prophylaxis group).
- During the prophylaxis period (1991-1993), 7/17 episodes of bacteraemia were streptococcal.
- The reduction in streptococcal bacteraemia following the initiation of penicillin V prophylaxis was statistically significant.
Conclusions:
- Oral penicillin V is an effective prophylactic agent against streptococcal bacteraemia in pediatric bone marrow transplant recipients.
- Implementing penicillin V prophylaxis can significantly lower the incidence of this serious complication.
- This strategy is particularly valuable in centers experiencing a high burden of streptococcal bacteraemia.
Abstract:
The work described aimed to evaluate the incidence of streptococcal bacteraemia in children undergoing bone marrow transplantation and receiving prophylaxis with penicillin V. From January 1991 to December 1993 oral penicillin V was administered as prophylaxis for streptococcal bacteraemia to patients undergoing bone marrow transplantation at G. Gaslini Children's Hospital, Genoa, Italy. The data were compared with those from a similar population receiving bone marrow transplantation from September 1984 to July 1990 and not receiving this kind of prophylaxis. Streptococcal bacteraemia was diagnosed in 7/17 (41%) episodes of bacteraemia observed in the period January 1991 to December 1993, while it accounted for 71% of all bacteraemias in the period from September 1984 to July 1990 and was especially frequent from January 1988 to July 1990, comprising 13/15 (87%) of observed bacteremias. The decrease of this complication observed after the beginning of the prophylaxis programme was statistically significant. Oral penicillin V is effective as prophylaxis of streptococcal bacteraemias in children receiving bone marrow transplantation in a centre with a high incidence of this complication.