A prospective controlled investigation of prophylactic trimethoprim/sulfamethoxazole in hospitalized granulocytopenic patients

Am J Med. 1979 Feb;66(2):248-56. doi: 10.1016/0002-9343(79)90539-4.

Abstract

Oral trimethoprim/sulfamethoxazole (TMP/SMZ) therapy was investigated in the prophylaxis of infections in granulocytopenia. Hospitalized granulocytopenic patients were allocated at random to receive TMP/SMZ (group 1) or to a control group (group 2). The percentage of febrile granulocytopenic days was significantly reduced in group 1, 19 per cent compared to 39 per cent in group 2 (P less than 0.01). In group 1, there were no bacteremias in 59 episodes of granulocytopenia (909 days). In group 2, there were nine bacteremias in 52 episodes of granulocytopenia (796 days)(P = 0.001). Disseminated candidiasis developed in two patients in each group. Candida occurred in similar numbers in surveillance cultures in both groups; Staphylococcus aureus and Pseudomonas aeruginosa were slightly decreased, and Enterobacteriaceae resistant to TMP slightly increased in group 1. This study suggest that oral prophylactic TMP/SMZ therapy is an effective, well tolerated, easily administered alternative to "gut sterilization" with nonabsorbable antibiotics.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Agranulocytosis / drug therapy*
  • Agranulocytosis / microbiology
  • Anti-Bacterial Agents / therapeutic use
  • Bacteriological Techniques
  • Clinical Trials as Topic
  • Cross Infection / prevention & control*
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Fever / prevention & control
  • Humans
  • Leukemia / drug therapy
  • Male
  • Middle Aged
  • Pneumonia / prevention & control
  • Prospective Studies
  • Sepsis / prevention & control
  • Sulfamethoxazole / therapeutic use*
  • Trimethoprim / therapeutic use*
  • Urinary Tract Infections / prevention & control

Substances

  • Anti-Bacterial Agents
  • Trimethoprim
  • Sulfamethoxazole