E.O.R.T.C. Gnotobiotic Project Group: a prospective cooperative study of antimicrobial decontamination in granulocytopenic patients. Comparison of two different methods

Abstract

In a cooperative and prospectively randomized study, two different methods of antimicrobial decontamination of the digestive tract with oral, nonabsorbable 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 data found in other studies using a combination of gentamicin, vancomycin and nystatin.