OBJECTIVES: We performed a meta-analysis to evaluate the impact of systemic antibiotic prophylaxis in hematopoietic stem cell transplantation (HSCT) recipients. METHODS: We collected reports from PubMed, the Cochrane Library, EMBASE, CINAHL, and Web of Science, along with references cited therein. We included prospective, randomized studies on systemic antibiotic prophylaxis in HSCT recipients. RESULTS: Seventeen trials with 1453 autologous and allogeneic HSCT recipients were included. Systemic antibiotic prophylaxis was compared with placebo or no prophylaxis in 10 trials and with non-absorbable antibiotics in two trials. Systemic antibiotics other than fluoroquinolones were evaluated in five of these 12 trials. Four trials evaluated the effect of the addition of antibiotics for gram-positive bacteria to fluoroquinolones. One trial compared two different systemic antibiotic regimens: fluoroquinolones versus trimethoprim-sulfamethoxazole. As a result, systemic antibiotic prophylaxis reduced the incidence of febrile episodes (OR 0.16; 95%CI 0.09-0.30), clinically or microbiologically documented infection (OR 0.38; 95%CI 0.22-0.63) and bacteremia (OR 0.31; 95%CI 0.16-0.59) without significantly affecting all-cause mortality or infection-related mortality. CONCLUSIONS: Systemic antibiotic prophylaxis successfully reduced the incidence of infection. However, there was no significant impact on mortality. The clinical benefits of prophylaxis with fluoroquinolones were inconclusive because of the small number of clinical trials evaluated.
OBJECTIVES: We performed a meta-analysis to evaluate the impact of systemic antibiotic prophylaxis in hematopoietic stem cell transplantation (HSCT) recipients. METHODS: We collected reports from PubMed, the Cochrane Library, EMBASE, CINAHL, and Web of Science, along with references cited therein. We included prospective, randomized studies on systemic antibiotic prophylaxis in HSCT recipients. RESULTS: Seventeen trials with 1453 autologous and allogeneic HSCT recipients were included. Systemic antibiotic prophylaxis was compared with placebo or no prophylaxis in 10 trials and with non-absorbable antibiotics in two trials. Systemic antibiotics other than fluoroquinolones were evaluated in five of these 12 trials. Four trials evaluated the effect of the addition of antibiotics for gram-positive bacteria to fluoroquinolones. One trial compared two different systemic antibiotic regimens: fluoroquinolones versus trimethoprim-sulfamethoxazole. As a result, systemic antibiotic prophylaxis reduced the incidence of febrile episodes (OR 0.16; 95%CI 0.09-0.30), clinically or microbiologically documented infection (OR 0.38; 95%CI 0.22-0.63) and bacteremia (OR 0.31; 95%CI 0.16-0.59) without significantly affecting all-cause mortality or infection-related mortality. CONCLUSIONS: Systemic antibiotic prophylaxis successfully reduced the incidence of infection. However, there was no significant impact on mortality. The clinical benefits of prophylaxis with fluoroquinolones were inconclusive because of the small number of clinical trials evaluated.
Authors: Dipenkumar Modi; Hyejeong Jang; Seongho Kim; Malini Surapaneni; Kamya Sankar; Abhinav Deol; Lois Ayash; Divaya Bhutani; Lawrence G Lum; Voravit Ratanatharathorn; Richard Manasa; Kendra Mellert; Pranatharthi Chandrasekar; Joseph P Uberti Journal: Support Care Cancer Date: 2017-04-02 Impact factor: 3.603
Authors: Karen Ballen; Kwang Woo Ahn; Min Chen; Hisham Abdel-Azim; Ibrahim Ahmed; Mahmoud Aljurf; Joseph Antin; Ami S Bhatt; Michael Boeckh; George Chen; Christopher Dandoy; Biju George; Mary J Laughlin; Hillard M Lazarus; Margaret L MacMillan; David A Margolis; David I Marks; Maxim Norkin; Joseph Rosenthal; Ayman Saad; Bipin Savani; Harry C Schouten; Jan Storek; Paul Szabolcs; Celalettin Ustun; Michael R Verneris; Edmund K Waller; Daniel J Weisdorf; Kirsten M Williams; John R Wingard; Baldeep Wirk; Tom Wolfs; Jo-Anne H Young; Jeffrey Auletta; Krishna V Komanduri; Caroline Lindemans; Marcie L Riches Journal: Biol Blood Marrow Transplant Date: 2016-06-22 Impact factor: 5.742