Canterbury DHB

Context

Summary of Antimicrobial Prophylaxis for SCT

In general this table applies to patients who have stable engraftment and are near to discharge from hospital. By definition neutrophils are more than 0.5 x 109/L.

Type

Autologous

Allogeneic – no GvHD

Allogeneic with GvHD

Bacterial

None.

Phenoxymethylpenicillin 500 mg BD PO for approximately 13 months.

Phenoxymethylpenicillin 500 mg BD PO for 18 months, or longer if GvHD persists.

Fungal

Fluconazole.

Fluconazole.

Posaconazole 300 mg PO BD for day 1 (omit if transferring directly from the oral liquid) then 300 mg PO ONCE daily.

Herpes Simplex

Past problems with HSV and/or is HSV seropositive – valaciclovir 500mg ONCE daily PO for one month post-SCT.

Past problems with HSV and/or is HSV seropositive – valaciclovir 500mg ONCE daily PO for one month post-SCT.

Past problems with HSV and/or is HSV seropositive – valaciclovir 500mg ONCE daily PO.

Herpes Zoster

If the patient is VZV seropositive, give valaciclovir 500mg BD PO for 12 months post-SCT.

If the patient is VZV seropositive, give valaciclovir 500mg BD PO for 12 months.

If the patient is VZV seropositive, give valaciclovir 500mg BD PO for 12 months, or for longer if GvHD persists.

Pneumocystis

trimethoprim + sulfamethoxazole 80 + 400 mg PO ONCE daily for six months post-transplant starting following stable engraftment.

trimethoprim + sulfamethoxazole 80 + 400mg PO ONCE daily for 12 months post-transplant starting following stable engraftment.

trimethoprim + sulfamethoxazole 80 + 400mg PO ONCE daily for six months post-transplant starting following stable engraftment, or for longer if GvHD persists.

CMV

This depends on the CMV serological status of the patient (and donor if relevant) as well as the type of SCT carried out. See CMV prophylaxis.

About this Canterbury DHB document (10217):

Document Owner:

Ruth Spearing and Sarah Metcalfe (see Who's Who)

Issue Date:

November 2016

Next Review:

November 2018

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 10217