What is the role of antibiotic prophylaxis in pediatric acute myelocytic leukemia (AML) treatment?

Updated: Sep 12, 2017
  • Author: Mark E Weinblatt, MD; Chief Editor: Jennifer Reikes Willert, MD  more...
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Answer

Prophylactic antibiotics have helped to decrease the incidence of a number of infections. Trimethoprim-sulfamethoxazole dramatically reduced the incidence of Pneumocystis (carinii) jiroveci pneumonia. In some centers, prophylactic penicillin has decreased the incidence serious systemic streptococcal sepsis in patients with severe mucositis. Acyclovir has been useful in preventing herpes simplex infections, particularly in patients who have undergone bone marrow transplantation.

Reports have suggested that prophylactic levofloxacin decreases the incidence of sepsis and other life-threatening infections. [18]

Many centers routinely administer fluconazole or nystatin prophylaxis to reduce the risk of fungal infections. Because of the significant incidence of life-threatening Enterococcal infections in this patient population, prophylaxis with penicillin or cephalosporins have also been advised.

Patients who develop GVHD that requires significant immunosuppressive therapy require more intense and more broadened infection prophylaxis.


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