Abstract
Globally, approximately 100,000 patients receive hematopoietic stem cell transplants (HCTs) annually, with increasing use for curative intent for many diseases (eg, leukemia, lymphoma).1 There is increasing recognition that antibiotic utilization may have a unique impact on this patient population by affecting both infection- and transplant-related outcomes.2,3 From an infection perspective, utilizing appropriate antibiotics is critically important: among patients with HCTs, there is a growing incidence of multidrug-resistant (MDR) infections, and potentially treatable infection is the primary cause of death in up to 20% of patients following allogenic HCT.3 Simultaneously, a growing body of literature suggests that decreased gastrointestinal microbiome diversity (which is associated with broad-spectrum antibiotic utilization) may worsen therapy response, acute graft-versus-host disease outcomes, and overall survival among patients with HCTs.2 Social and structural determinants of health have also proven to be important determinants of health outcomes among patients with cancer generally.
