Sometimes, doctors prescribe antibiotics when a person’s ANC is very low — even though there is no sign of an infection. These can be anti-bacterial, anti-viral, and/or anti-fungal drugs. You may hear this called prophylactic antibiotic use, or just prophylaxis. The drugs are given to help keep you from getting an infection.
Prophylaxis is only used when there is a very high risk of getting infections, for example, if you are expected to have severe neutropenia for a week or longer. Antibiotics may also be given if you are on other medicines that can make your immune system weak, such as a long course of steroids or some immunotherapy drugs.
The prophylactic antibiotics are stopped when your ANC improves or the immune weakening drugs are stopped. Using antibiotics in this way does not prevent all infections, so it is still important to use the same precautions as when you are not taking prophylactic antibiotics.
Use of growth factors
Growth factors are proteins your body makes to help your blood cells grow. They are also known as colony-stimulating factors (CSFs).
Man-made CSFs are most often used after chemo to keep your white blood cell (WBC) count up and help prevent infection. You may be given a CSF before a cycle of chemo to help your WBCs grow and keep your absolute neutrophil count (ANC) from getting too low. Or, you may get it when your ANC is low to help build it back up. Your doctor also may give you a CSF if your ANC is low and you have a serious infection that is getting worse even though you are getting treatment.
CSF drugs used today include filgrastim (Neupogen®) and pegfilgrastim (Neulasta®), which affect the neutrophils. Sargramostim (Leukine®) is a CSF that affects neutrophils, monocytes, and macrophages. All of these medicines shorten the length of time a person is neutropenic (low on neutrophils) and make the shortage of WBCs and neutrophils less severe.
Growth factors do have side effects that can be serious in some people, but they can reduce the risk of infection in the patients who need them. You can call us to get more information on each of these drugs.
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