INFECTION PREVENTION IN AUTOLOGOUS BONE-MARROW TRANSPLANTATION AND THE ROLE OF PROTECTIVE ISOLATION

The efficacy of an antimicrobial regimen for prevention of infections was prospectively evaluated in 113 patients undergoing autologous bone marrow transplantation (BMT). Ciprofloxacin, 500 mg orally twice a da y plus antifungal prophylaxis, fluconazole 50 mg once daily plus ampho tericin B tablets or suspension and tablets, each 200 mg four times a day, was given. In addition all patients received streptococcal prophy laxis for 10 days after BMT. Documented infections occurred in 39% (44 of 113) of patients and unexplained fever in 27% (30 of 113). The eff icacy of this regimen was reflected in a low mortality rate (3.5%) fro m infections and in the low need for intravenous amphotericin B (7%). No benefit of protective isolation was found in 59 patients compared w ith 54 patients treated without isolation measures.