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Vol 52, No 6 (2021)
Guidelines / Expert consensus
Published online: 2021-10-11

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Antimicrobial prophylaxis in adults and children undergoing hematopoietic cell transplantation: 2021 Polish recommendations

Jan Styczynski1, Agnieszka Piekarska2, Agnieszka Zaucha-Prażmo3, Jan Maciej Zaucha2, Olga Zając-Spychała4, Tomasz Wróbel5, Agnieszka Wierzbowska6, Adam Walter-Croneck7, Jacek Wachowiak4, Marek Ussowicz8, Tomasz Szczepański9, Agnieszka Sobkowiak-Sobierajska4, Małgorzata Sobczyk-Kruszelnicka10, Katarzyna Smalisz11, Mariola Sędzimirska12, Piotr Rzepecki13, Beata Piątkowska-Jakubas14, Anna Łojko15, Ewa Lutwin16, Ewa Lech-Marańda17, Bogusław Machaliński18, Aleksandra Krasowska-Kwiecień19, Krzysztof Kałwak8, Marek Hus7, Iwona Hus17, Grzegorz Helbig20, Dorota Hawrylecka21, Kazimierz Hałaburda17, Jolanta Goździk19, Sebastian Giebel10, Adam Fronczak6, Jarosław Dybko12, Agnieszka Druzd-Sitek22, Katarzyna Drabko3, Krzysztof Czyżewski1, Anna Czyż5, Edyta Cichocka23, Piotr Boguradzki24, Maria Bieniaszewska2, Bartłomiej Baumert18, Grzegorz Basak24, Lidia Gil15
DOI: 10.5603/AHP.a2021.0097
Acta Haematol Pol 2021;52(6):528-542.

Abstract

Infections are still a major reason of morbidity and one of the most common causes of death after hematopoietic cell transplantation (HCT). Antimicrobial prophylaxis plays a crucial role in decreasing non-relapse mortality after HCT. The objective of this guideline paper is presentation of current recommendations of antimicrobial prophylaxis for children and adults after hematopoietic cell transplantation, prepared in cooperation of Polish scientific hematological societies. Recommendations were prepared by the working group and finally approved by all 23 Polish transplant centers for children and adults. Existing ECIL (European Conference on Infections in Leukemia) and EBMT (European Society of Blood and Marrow Transplantation) guidelines, as well as results of survey performed among all Polish transplant centers, were the background material for working group. Recommendations are presented in sections dedicated to antibacterial prophylaxis, antifungal prophylaxis, antiviral prophylaxis, as well as prophylaxis of toxoplasmosis and infections with Pneumocystis jiroveci. Recommendations on principles of vaccination against COVID-19 are provided based on the state of knowledge in September 2021. A section on guidelines of environmental prophylaxis is also presented.

Keywords: hematopoietic cell transplantationchildrenadultsincidenceoutcomebacterial infectionsviral infectionsinvasive fungal disease

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