Low Bacterial Diet in Patients With Cytopenia
Low Bacterial Diet in Patients With Cytopenia
The purpose of this prospective, randomized study was to determine the efficacy of low
 bacterial diet, in comparison to normal hospital diet, with gut colonization by aerobic Gram
 negative rods and yeasts as primary endpoint. In addition, the occurrence of infections and
 the total costs of hospital care were documented, in order to identify potential cost savings
 by the use of either diet.
Patients with hematological malignancies who receive intensive chemotherapy usually develop a
 period of cytopenia, during which there is an increased risk of infection. Mucositis can also
 develop in these patients, enabling micro-organisms, belonging to the endogenous intestinal
 flora, to translocate from the intestine to the lymphoid tissue and blood. Therefore, when
 mucositis and cytopenia develop simultaneously, the risk of infection increases further. In
 this regard bloodstream infection by Gram negative rods and yeasts are an important cause of
 serious infections causing considerable morbidity.

 In order to reduce the risk of infection several preventive measures have been adopted.
 Fundamentally, all of these measures were designed to prevent either acquisition of Gram
 negative rods or fungal pathogens from the environment, or the translocation of these
 potential pathogens across the mucosal barrier of the gut. These measures include protective
 (or reverse) isolation, antibiotic prophylaxis with antibiotics which selectively eradicate
 the aerobic Gram negative rods and yeasts from the gut flora, and finally the use of
 low-bacterial diets.

 In this prospective, randomized study on the efficacy of low bacterial diet, in comparison to
 normal hospital diet, gut colonization by aerobic Gram negative rods and yeasts, the
 occurrence of infections and the total costs of hospital care were chosen as study endpoints.
Inclusion Criteria:

 -  acute leukemia receiving remission induction chemotherapy

 -  receiving antibiotic prophylaxis for cytopenia leukocytes lower than 1000/mm3 in
 peripheral blood)

 -  informed consent

 Exclusion Criteria:

 -  none