Successful treatment of recurrent bacteraemia by selective digestive decontamination with kanamycin in a lung cancer patient receiving chemotherapy.

INTRODUCTION

is an enterohepatic species causing bacteraemia in immunocompromised hosts. Only a few cases of recurrent bacteraemia have been reported in Japan and there are no guidelines regarding antimicrobial treatment for infection.

CASE PRESENTATION

bacteraemia was observed in a patient receiving platinum-based chemotherapy for lung cancer. To prevent recurrence, the patient received antibiotic therapy with cefepime, amoxicillin and doxycycline for 6 weeks, which is similar to the therapy for bacteraemia. Bacteraemia recurred despite the long-term antibiotic therapy. We hypothesized that the bacteraemia originated from endogenous infection in the intestinal tract due to the long-term damage of the enteric mucosa by platinum-based drugs and performed selective digestive decontamination (SDD) with kanamycin. Bacteraemia did not recur after SDD.

CONCLUSION

Our observations indicate that clinicians should be aware of possible recurrent bacteraemia, which could be effectively prevented by SDD with kanamycin.