Rethinking Antimicrobial Prophylaxis in the Transplant Patient in the World of Emerging Resistant Organisms-Where Are We Today?

被引：18

作者：

Horton, Lucy E. ^{[1
]}

Haste, Nina M. ^{[2
]}

Taplitz, Randy A. ^{[1
]}

机构：

[1] Univ Calif San Diego, Dept Med, Div Infect Dis & Global Publ Hlth, 9500 Gilman Dr,Mail Code 0960, La Jolla, CA 92093 USA

[2] Univ Calif San Diego, Dept Pharm, 9500 Gilman Dr, La Jolla, CA 92093 USA

来源：

CURRENT HEMATOLOGIC MALIGNANCY REPORTS | 2018年 / 13卷 / 01期

关键词：

Hematopoietic stem cell transplant (HSCT); Bone marrow transplant (BMT); Neutropenia; Antibiotic prophylaxis; Graft-versus-host-disease; (GVHD); microbiome; STEM-CELL TRANSPLANTATION; CLOSTRIDIUM-DIFFICILE INFECTION; BLOOD-STREAM INFECTIONS; VERSUS-HOST-DISEASE; ACUTE NONLYMPHOCYTIC LEUKEMIA; INTESTINAL MICROBIOTA; BACTERIAL-INFECTIONS; NEUTROPENIC PATIENTS; MARROW-TRANSPLANTATION; KLEBSIELLA-PNEUMONIAE;

D O I：

10.1007/s11899-018-0435-0

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose of Review The use of prophylactic antibiotics during the neutropenic period in hematopoietic stem cell transplantation has been the standard of care at most institutions for the past 20 years. We sought to review the benefits and risks of this practice. Recent Findings Emerging data has highlighted the potential costs of antibacterial prophylaxis, from selecting for antibiotic resistance to perturbing the microbiome and contributing to increase risk for Clostridium difficile and perhaps graft-versus-hostdisease, conditions which may lead to poorer outcomes. Summary Though in many studies prophylactic antibiotics improved morbidity and mortality outcomes, the potential harms including antibiotic resistance, Clostridium difficile infection, and alterations of the gut microbiome should be considered. Future studies aimed to better risk-stratify patients and limit the use of broad-spectrum antibiotics are warranted.

引用

页码：59 / 67

页数：9

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