Infection Prophylaxis in Acute Leukemia: Comparative Effectiveness of Sulfamethoxazole and Trimethoprim, Ketoconazole, and a Combination of the Two

Elihu Estey, Andrew Maksymiuk, Terry Smith, Victor Fainstein, Michael Keating, Kenneth B. McCredie, Emil J. Freireich, Gerald P. Bodey

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65 Scopus citations

Abstract

In a comparative study of infection prophylaxis, patients with acute leukemia receiving remission induction therapy were assigned either no prophylaxis, sulfamethoxazole and trimethoprim, ketoconazole, or the combination of sulfamethoxazole and trimethoprim and ketoconazole. Both sulfamethoxazole and trimethoprim and the combination of sulfamethoxazole and trimethoprim and ketoconazole substantially reduced the overall incidence of infection consequent to a marked decrease in bacterial infection. However, sulfamethoxazole and trimethoprim were associated with an increased rate of fungal infection, while ketoconazole decreased this complication. No form of prophylaxis reduced infectious mortality or increased the complete remission rate. However, because of its effect in reducing infectious morbidity, we conclude that patients with acute leukemia receiving remission induction treatment should be given antibacterial and antifungal prophylaxis.

Original languageEnglish (US)
Pages (from-to)1562-1568
Number of pages7
JournalArchives of Internal Medicine
Volume144
Issue number8
DOIs
StatePublished - Aug 1984

ASJC Scopus subject areas

  • Internal Medicine

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