Increased GVHD-related mortality with broad-spectrum antibiotic use after allogeneic hematopoietic stem cell transplantation in human patients and mice

Intestinal bacteria may modulate the risk of infection and graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Allo-HSCT recipients often develop neutropenic fever, which is treated with antibiotics that may target anaerobic bacteria in the gut. We retrospectively examined 857 allo-HSCT recipients and found that treatment of neutropenic fever with imipenem-cilastatin and piperacillin-tazobactam antibiotics was associated with increased GVHD-related mortality at 5 years (21.5% for imipenem-cilastatin-treated patients versus 13.1% for untreated patients, P = 0.025; 19.8% for piperacillin-tazobactam-treated patients versus 11.9% for untreated patients, P =…

• AS
  American Society of Hematology
• LF
  Lymphoma Foundation
• AS
  American Society for Blood and Marrow Transplantation
• NI
  National Institutes of Health

  Awards: R00-CA176376, R01-AI100288, R01-AI101406, R01-HL124112, R01-AI080455, R01-HL069929, P30 CA008748-48
• MR
  Medical Research Council
• NC
  National Cancer Institute

  Award: P30-CA008748
• NI
  National Institute of Allergy and Infectious Diseases