PROSPECTIVE CONTROLLED INVESTIGATION OF PROPHYLACTIC TRIMETHOPRIM-SULFAMETHOXAZOLE IN HOSPITALIZED GRANULOCYTOPENIC PATIENTS

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 < 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 suggests that oral prophylactic TMP/SMZ therapy is an effective, well tolerated, easily administered alternative to gut sterilization" with nonabsorbable antibiotics. © 1979."