Effect of Neutropenic Diet on Neutropenic Patient

Executive Summary

Patients with both hard lumps and hematological malignances getting high dose chemotherapy have a considerably enlarged possibility of acquiring serious infections. In patients with serious neutropenia, the infection-related death rate is about 4% to 6% in adult patients and in pediatric patients; mortality rate is 0.4% to 1.0%. In neutropenic patients, about 80% of the organisms inducing infections stem from endogenic microbial flora colonizing the skin and genitourinary, respiratory, and GITs. Though not germ-free, elimination of foods with high bacterial counts was the aim of making this diet. The National Cancer Institute, in a randomized trial, verified that regarding bacterial stool cultures, a germ-free diet, within a cleansed environment, provided little benefit above a prepared-food diet. Though, as compared to the germ-free diet, the diet of cooked food was more satisfactory to patients, patients who, more than four to six weeks, stuck to this diet often became discomfited with the food choice. The neutropenic diet or the low bacterial diet is another name for this liberalized diet. In patients with neutropenia, there is still a controversy in role of diet in the risk of infection. Some do not cause patients to consume this diet, because there are not enough clinical trial results that prove to be beneficial for patients.

The neutropenic diet is known as a low bacterial diet (LBD), a low microbial diet, or sterile diet. Nevertheless, a standardized definition has not been established for the neutropenic diet . A completely sterile diet (the entire foods that have been through baking, canning, irradiation or, autoclaving made sterilized), house diet with modification (i.e., a normal diet excluding fresh vegetables and fruits) or a LBD (only well-cooked foods) are consisted of the variations of the neutropenic diet. Scientifically, the benefit of the neutropenic diet has never been confirmed. In spite of this, in many institutions, neutropenic diets are used. Todd et al. (1979) carried out a descriptive telephone survey, in 21 children's' hospitals, for investigating the usage of LBDs for chemotherapy-induced neutropenia and establish that neutropenic diet was used by (a) 43% of these hospitals for neutropenic non- bone marrow transplant patients and (b) 86% of these hospitals for bone marrow transplant patients. A major source of casualty is infection in all cancer patients. The LBD or neutropenic diet is generally applied merely when a patient happens to neutropenic, and regular dietetic patterns are recommenced afterward. Patients with less than 500 cells/ mm counts, for more than a few days, are at higher risk of severe infections. Infections are of much concern, in seriously neutropenic patients, as sepsis or death may be resulted by them. Because of organisms that can be detected in raw food, the chances of overgrowth of bacteria might be increased in the bowel of a patient with neutropenia and consequently directing to general infection. In the neutropenic patient, the presumption and aim of the neutropenic diet is to likely lessen the risk of infections and sepsis caused by bacteria and ...