Prophylactic non-absorbable antibiotics in leukaemic patients

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Abstract
Summary: A regimen of oral non-absorbable prophylactic antibiotics (kanamycin–vanco–mycin–nystatin) was given to nine severely neutropaenic leukaemic patients on cytotoxic therapy (11 courses), in conjunction with isolation procedures. An appreciable decrease in faecal organisms, especially anaerobes, was apparent after 48 h of commencing the course, and most bacteria had disappeared from the stool after five days. There were three episodes of septicaemia, all with enteric organisms, whilst on these antibiotics; one proved fatal. The emergence of resistance to aminoglycosides in faecal flora, notablyKlebsiella, in 6/11 courses constituted a major problem in the use of such prophylaxis.