THE ROLE OF PROPHYLACTIC ANTIBIOTICS IN HEMATOPOIETIC STEM CELL TRANSPLANTATION

Abstract

Infection in marrow transplant recipients is determined primarily by the evolving immunologic milieu of each patient. Profound neutropenia and disruption of anatomic barriers are the most important risk factors for bacterial and fungal infections in the initial period after transplant. After this period, the occurrences of acute and then chronic graft-versus-host disease (GVHD) are the most important influences on the risk of infection. Major infections after the period of initial engraftment include viral infections (especially cytomegalovirus), fungal infections (due to Aspergillus and Candida), and rarely protozoal infections. GVHD appears to increase both the incidence and severity of cytomegalovirus infection. Bacterial infections also continue to occur, due predominantly to coagulase-negative Staphylococcus, as in the neutropenic period. Patients with chronic GVHD have continued abnormalities of host defenses, which may be further suppressed by treatment for GVHD. Our study was aimed to investigate the role of using prophylactic Levofloxacin in Egyptian patients subjected to allogenic HSCT and its relation to outcome. Our retrospective study included 60 patients who presented in Bone Marrow Transplantation unit at Nasser Institute Hospital in Cairo,Egypt treated by allogenic HSCH at time period from 2009 to 2013,patients were divided into two groups. Group A:patients were not treated with prophylactic Levofloxacine. Group B:patients were treated with prophylactic Levofloxacine.