Review Article

Antibiotic Therapy and Gastrointestinal Graft-Versus-Host Disease in the Allogeneic Stem Cell Transplantation Population

Jessica Thomas, MSN, APRN, FNP-C, AOCNP®, Christi Bowe, MSN, APRN, ANP-C, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

From The University of Texas MD Anderson Cancer Center, Houston, Texas

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Jessica Thomas, MSN, APRN, FNP-C, AOCNP®, 1515 Holcombe Boulevard, Houston, TX 77030. E-mail: jothomas1@mdanderson.org


J Adv Pract Oncol 2022;13(1):61–69 | https://doi.org/10.6004/jadpro.2022.13.1.5 | © 2022 Harborside™


  

ABSTRACT

Purpose: Hematopoietic stem cell transplantation patients undergo rigorous courses of myeloablative chemotherapy that increase vulnerability for infections. Complications can arise in the form of graft-vs.-host disease (GvHD) manifesting in various organs, including the skin, lung, liver, and gastrointestinal (GI) tract. Antibiotic therapy is generally begun in order to prevent further complications from infection but may increase the risk for acute GI GvHD. Studies that investigated antibiotic therapy and the subsequent occurrence of GI GvHD in allogeneic stem cell transplantation (aSCT) patients were reviewed. Methods: PubMed, Scopus, and CINAHL databases were utilized. Articles published between January 1, 2009, and December 15, 2019, were included in this review. A total of 1,142 articles were retrieved. Duplicates, reviews, letters to the editors, irrelevant interventions/outcomes, and non-English articles were excluded. Inclusion criteria included individuals who were undergoing an aSCT and received antibiotic therapy. A total of seven articles were included for this review after applying the inclusion and exclusion criteria. Results: The use of broad-spectrum antibiotics increased the risk of developing GI GvHD. Stool analysis when available showed a decrease in the diversity of the gut microbiome, which in turn led to the increase in acute GvHD. Implications: The increased risk of GvHD may have implications for the standard of care therapy, which includes treatment, for infections during SCTs. Providers will need to weigh the risk vs. benefit of antibiotic therapy and exercise judicious selection of antibiotics prior to engraftment.




For access to the full length article, please sign in.

Section Seperator
ADVERTISEMENT
Section Seperator
ADVERTISEMENT
Section Seperator
ADVERTISEMENT
Section Seperator
Copyright © 2010-2022 Harborside Press, LLC All rights reserved.               
Home | Current Issue | Previous Issue | Submissions | About JADPRO | Advertising | Privacy Policy | Contact | Copyright Notice/Disclaimer | Subscribe
Bot trap - Don't go here
By continuing to browse this site you permit us and our partners to place identification cookies on your browser and agree to our use of cookies to identify you for marketing. Read our Privacy Policy to learn more.