Abstract
Increasing importance of preventive and therapeutic measures for concurrent microbial infections during induction therapies for acute leukemia is recognized. Infections account for approximately 60% of the direct cause of death in patients with acute leukemia. Septicemias from gram-negative rods of enteric origin are major threat in patients with extreme neutropenia. “Intestinal sterilization” was attempted in 14 patients with acute leukemia under induction therapy by the combined oral use of gentamicin, kanamycin and amphotericin B in association with well-cooked dietary regimen. Serial quantitative stool cultures for aerobic, anaerobic and fungal organisms revealed that “intestinal sterilization” was effective in suppressing fecal flora in significantly high percentages of specimens. The cessation of oral antibiotic regimen and well-cooked diet was followed by a prompt return of fecal flora, however. The incidence of febrile episodes while patients were on “intestinal sterilization” schedule was lower than that of a control group of patients under the similar morbid situation without “intestinal sterilization”. This difference was not statistically significant. Anorexia and nausea were common, but they were generally mild and did not necessitate interruption of the regimen. “Intestinal sterilization” appears to deserve further study as a supportive therapy for the treatment of acute leukemia.
