1988 Volume 62 Issue 6 Pages 527-533
To evaluate gut decontamination by three regimens consist of vancomycin 750 mg/m2/day, polymyxin B 3×106 units/m2/day, and nystatin 1.5×106 units/m2/day (VPN), or amphotericin B in place of nystatin with two different doses of 150 mg/m2/day (VPA150), and 500 mg/m2/day (VPA500), 29 patients who received bone marrow graft were enrolled in this study.
Total decontamination of intestinal flora was achieved by all three regimens. Candida was isolated from 10 out of 14 patients who received VPN, and 5 out of 5 patients who received VPA150, but only one out of 10 patients treated by VPA500. In these patients, one patients who had failed to achieve engraftment died of systemic candidiasis.
Pseudomonas was isolated from 3 out of 14 patients who received VPN, one out of 5 patients who received VPA150, and 5 out of 10 patients treated by VPA500. Among the patients showing pseudomonas colonization, one patient died of pseudomonas sepsis.
In conclusion, intestinal candidiasis may by prevented by the VPA500 regimen, but psedomonas colonization seems to be a further problem in gut decontamination in bone marrow transplantation.
