Summary
In a cooperative and prospectively randomized study, two different methods of antimicrobial decontamination of the digestive tract with oral, non-absorbable antibiotics were compared in neutropenic patients. In the first treatment group, the antibiotics were selected on the basis of the outcome of sensitivity tests performed on the flora of the patients. The other treatment group was given a standard combination of neomycin, cephaloridin, polymyxin B or E and nystatin or amphotericin B. Complete data from a total of 35 patients were received at the Statistical Center, and a minimum of 1.5 oral washings and faecal samples per week arrived at the Central Bacteriological Laboratory. There was no substantial difference in the clinical parameters of the patients in both treatment groups. Both methods for decontamination were found to be effective. The incidence of acquired infections and the quality of decontamination were almost identical in both groups. As far as the average number of negative cultures per patient is concerned, the results for both treatment groups are well in line with the data found in other studies using a combination of gentamicin, vancomycin and nystatin.
Zusammenfassung
In einer kooperativen prospektiv randomisierten Studie wurden zwei verschiedene Verfahren der totalen antimikrobiellen Dekontamination des Verdauungstrakts mit oralen, nicht resorbierbaren Antibiotika bei granulozytopenischen Patienten miteinander verglichen. In der ersten Therapiegruppe wurden die Antibiotika aufgrund einer Sensibilitätstestung der Bakterien der Darmflora ausgewählt. Die andere Therapiegruppe erhielt eine Standardkombination aus Neomycin, Cephaloridin, Polymyxin B oder E und Nystatin oder Amphotericin B. Von insgesamt 35 Patienten erhielt das Statistische Zentrum komplette Datensätze und das bakteriologische Zentrallabor mindestens 1,5 Proben pro Patient pro Woche von Rachenspülflüssigkeit und Stuhl. Die klinischen Parameter der Patienten beider Therapiegruppen unterschieden sich nicht wesentlich. Beide Verfahren der antimikrobiellen Dekontamination erwiesen sich als wirksam. Die Qualität der Dekontamination war in beiden Therapiegruppen nahezu identisch. Auch in der Häufigkeit von erworbenen Infektionen ergaben sich keine signifikanten Unterschiede. Die Häufigkeit negativer Kulturen war vergleichbar mit den Ergebnissen anderer Studien, in denen eine Kombination von Gentamicin, Vancomycin und Nystatin angewandt wurde.
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Prof. Dr.W. Gaus, Abteilung Klinische Dokumentation, Universität Ulm, Eyth-Straße 2, D-7900 Ulm;
Dr.E. Kurrle, Department für Innere Medizin, Abteilung Innere Medizin III, Universität Ulm, Steinhövelstraße 9, D-7900 Ulm;
Prof. Dr.G. Linzenmeier, Institut für Medizinische Mikrobiologie, Universität Essen, Hufelandstraße 55, D-4300 Essen;
Dr.M. R. Nowrousian, Tumor-Klinik, Universität Essen, Hufeland-straße 53, D-4300 Essen;
Dr.H. de Vries-Hospers, Prof. Dr.D. van der Waaij, Laboratory for Medical Microbiology R. U., Oostersingel 59, 9713 EZ Groningen, The Netherlands.
Requests for reprints: Prof. Dr.D. van der Waaij
Writing Committee for the Gnotobiotic Project Group:W. Gaus, E. Kurrle, G. Linzenmeier, R. Nowrousian, H. de Vries-Hospers, D. van der Waaij
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E.O.R.T.C. Gnotobiotic Project Group. A prospective cooperative study of antimicrobial decontamination in granulocytopenic patients. Comparison of two different methods. Infection 10, 131–138 (1982). https://doi.org/10.1007/BF01640762
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DOI: https://doi.org/10.1007/BF01640762