From Standard of Care
Utilized for patients with prolonged, severe neutropenia, patients receiving bone marrow or stem cell transplantation or for patients with severe but transient neutropenia.
In a study in 1973 of 88 patients undergoing induction chemotherapy for acute leukemia randomized to oral non absorbable antibiotics alone, a protected environment, or neither: while there was a reduction in infections in the protected environment, with reduced sort-term mortality, there was no long-term survival benefit (Levine).
In a randomized study of 116 patients with AML treated with: ward care, ward care with reverse isolation with topical and oral antibiotics, total barrier isolation without antibiotics, or total barrier isolation with topical and oral antibiotics: results-fewer infections in the barrier isolated patients after the fist 3 weeks, fewer respiratory infections were respiratory in the isolated patients, and no difference in survival among the groups (Yates).
64 patients with AML undergoing induction chemotherapy randomized to laminar flow reverse isolation, oral non absorbable antibiotics and routine ward care with non absorbable antibiotics, or routine ward care alone: fewer patients in isolation died as a result of infection than in routine ward care group, complete remission rate and overall survival higher in both groups receiving oral antibiotics, than in the standard ward care group (Schimpff).
The European Organization for Research on Treatment of Cancer evaluated 137 patients with acute leukemia and randomized three groups: protective isolation and non absorbable antibiotics, protective isolation, and routine ward care-no difference in occurrence of severe infections, or in the rate of remission or survival, but the isolation groups had fewer respirator infections than the ward care group (Dietrich D).