Bodey G P
Rev Infect Dis. 1981 Nov-Dec;3 suppl:S259-68.
The high frequency of complications caused by infections during therapy of malignant diseases has led to the development of prophylactic programs. The most effective prophylaxis has included the use of protected environments and antibiotic regimens (PEPA). Most oral prophylactic regimens include vancomycin to provide coverage against aerobic, gram-positive cocci and some anaerobes. Regimens of nonabsorbable antibiotics are effective in eliminating the vast majority of bacteria from the stool, but the antifungal agents are less effective. However, once the antibiotic regimen is discontinued, organisms previously cultured will reappear. Several prospective, randomized studies have been conducted of patients with acute leukemia who are undergoing chemotherapy administered to induce remission. The frequency of complications caused by infection has been significantly lower for patients in the PEPA program than for controls. A recent study of patients with lymphoma has shown that patients in the PEPA program can tolerate higher doses of chemotherapy than can control patients and that they have lower frequency of complications caused by infection.
恶性疾病治疗期间感染引起的并发症发生率较高，促使预防性方案得以发展。最有效的预防措施包括使用保护环境和抗生素方案（PEPA）。大多数口服预防方案包括使用万古霉素，以覆盖需氧革兰氏阳性球菌和一些厌氧菌。不可吸收抗生素方案在清除粪便中的绝大多数细菌方面有效，但抗真菌剂效果较差。然而，一旦停用抗生素方案，先前培养出的微生物就会再次出现。针对接受诱导缓解化疗的急性白血病患者进行了几项前瞻性随机研究。PEPA方案组患者感染引起的并发症发生率明显低于对照组。最近一项针对淋巴瘤患者的研究表明，PEPA方案组患者比对照组患者能够耐受更高剂量的化疗，且感染引起的并发症发生率更低。
