30 years ago, HSCT was developed as a treatment for many congenital and acquired bone marrow disorders and cancers that are sensitive to chemical and radiation therapy. Mortality is considered as a major barrier in HSCT. Infections were identified as a significant contributor to mortality and morbidity during the pancytopenia period and they are considered as a treatable situation. [1]
Infection has been reported as primary cause of death in 8% of autologous transplant patients and 17-20% of allogeneic transplant recipients. [2]
Bacteremia and invasive bacterial infections are common among children receiving bone marrow transplants. Systemic antibacterial prophylaxis is one of the approaches that can reduce the risk of these infections.Bacterial pneumonia and gram negative bacteria are very common after HSCT. [3]
Using Fluoroquinolones significantly reduces the risk of Gram-negative bacteria. A study in a pediatric population found no evidence of acute arthritis or serious liver and kidney disease caused by Ciprofloxacin. [4]
This study was performed as an open label on 80 children admitted to the transplant department. Patients were randomly divided into two groups of 35 patients. The intervention group received Ciprofloxacin at a dose of 10 mg/kg twice daily and the control group received Ceftazidime at a dose of 50 mg/kg 3 times daily. Other interventions were the same between the two groups.
- A. Gratwohl, R. Brand, F. Frassoni, V. Rocha, D. Niederwieser, P. Reusser, H. Einsele, and C. Cordonnier, “Cause of death after allogeneic haematopoietic stem cell transplantation (HSCT) in early leukaemias: an EBMT analysis of lethal infectious complications and changes over calendar time,” Bone Marrow Transplant., vol. 36, no. 9, pp. 757– 769, Nov. 2005.
- M. Tomblyn, T. Chiller, H. Einsele, R. Gress, K. Sepkowitz, J. Storek, J. R. Wingard, J.-A. H. Young, and M. J. Boeckh, “Guidelines for preventing infectious complications among hematopoietic cell transplant recipients: a global perspective,” Bone Marrow Transplant., vol. 44, no. 8, pp. 453–455, Oct. 2009.
- T. Lehrnbecher, B. T. Fisher, B. Phillips, S. Alexander, R. A. Ammann, M. Beauchemin, F. Carlesse, E. Castagnola, B. L. Davis, L. L. Dupuis, G. Egan, A. H. Groll, G. M. Haeusler, M. Santolaya, W. J. Steinbach, M. van de Wetering, J. Wolf, S. Cabral, P. D. Robinson, and L. Sung, “Guideline for Antibacterial Prophylaxis Administration in Pediatric Cancer and Hematopoietic Stem Cell Transplantation,” Clin. Infect. Dis., Nov. 2019.
- C. Mullen, J. Nair, S. Sandesh, and K. Chan, “Fever and neutropenia in pediatric hematopoietic stem cell transplant patients,” Bone Marrow Transplant., vol. 25, no. 1, pp. 59–65, Jan. 2000.