A Co-operative Study on Prophylaxis of Fungal Infection in Patients with Hematological Diseases: Prophylactic Effect of Oral Administration of Amphotericin B

Abstract

The purpose of this study is to determine the prophylactic effect of orally administered amphotericin B (AMPH-B) for the prevention of systemic fungal infections in patients with acute leukemia, malignant lymphoma or multiple myeloma. On admission, half of these were randomly assigned to receive oral as well as gurgle administration of AMPH-B in doses large enough to suppress overgrowth of fungus in the intestinal tract and mouth. The others received no prophylactic administrations.
Although there was no difference in terms of the prevention of development of severe systemic fungal infections between the two groups, cultures obtained from the stool and saliva of patients who received AMPH-B showed significantly decreased positivity as compared with those of patient without AMPH-B.
It is suggested that even if the patient becomes severely ill and impossible to take the drugs orally, the administration of AMPH-B should be continued in a possible way for the prevention of the development of sytemic fungal infection because the risk of the development is very high in these patients.