Bossù Gianluca, Di Sario Riccardo, Argentiero Alberto, Esposito Susanna
Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, 43126 Parma, Italy.
Antibiotics (Basel). 2021 Feb 3;10(2):152. doi: 10.3390/antibiotics10020152.
In children with cancer, chemotherapy can produce cytotoxic effects, resulting in immunosuppression and an augmented risk of febrile neutropenia and bloodstream infections. This has led to widespread use of antibiotic prophylaxis which, combined with intensive chemotherapy treatment, could have a long-term effect on the gastrointestinal microbiome. In this review, we aimed to analyze the current literature about the widespread use of antibiotic prophylaxis in children experiencing infectious complications induced by chemotherapy and its effects on the gut microbiome. Our review of the literature shows that antimicrobial prophylaxis in children with cancer is still a trending topic and, at the moment, there are not enough data to define universal guidelines. Children with cancer experience long and painful medical treatments and side effects, which are associated with great economic and social burdens, important psychological consequences, and dysbiosis induced by antibiotics and also by chemotherapy. Considering the importance of a healthy gut microbiota, studies are needed to understand the impact of dysbiosis in response to therapy in these children and to define how to modulate the microbiome to favor a positive therapeutic outcome.
在患癌儿童中，化疗会产生细胞毒性作用，导致免疫抑制以及发热性中性粒细胞减少和血流感染风险增加。这使得抗生素预防措施被广泛使用，而抗生素预防措施与强化化疗相结合，可能会对胃肠道微生物群产生长期影响。在本综述中，我们旨在分析当前有关抗生素预防措施在化疗引起的感染性并发症患儿中广泛使用的文献及其对肠道微生物群的影响。我们对文献的综述表明，癌症患儿的抗菌预防仍然是一个热门话题，目前尚无足够数据来制定通用指南。患癌儿童要经历漫长而痛苦的医疗治疗及副作用，这会带来巨大的经济和社会负担、重要的心理后果，以及由抗生素和化疗引起的生态失调。鉴于健康的肠道微生物群的重要性，需要开展研究以了解这些儿童治疗过程中生态失调的影响，并确定如何调节微生物群以促进积极的治疗效果。
