Efficacy of Low Microbial Diet in Immunocompromised Adult Bone Marrow Transplant Patients

A Low Microbial Diet has been introduced to patients who are immunocompromised in an effort to reduce the risk of sepsis.  There has been a continued discrepancy among Medical Institutions in practicing the use of Low Microbial Diets also known as Neutropenic Diet. It is a controversy because every hospital delivers care differently guided by their individual research and belief. Although this dietary practice seems reasonable and prudent, there is still a lack in evidence and literature to support the practice making it weak and questionable. The purpose of this review is to decipher the effectiveness of “Low Microbial Diet” in immunocompromised adult bone marrow transplant patients. It will also identify the controversial efficacy and validity of the diet by reviewing any evidence based literature that supports claims for use and effectiveness. A literature search was undertaken using the Cochrane Database of Systematic Reviews, and Pubmed, from 2006 to 2011, to reveal any changes or attempt to evaluate the validity of Low Microbial Diet in the Blood and Marrow Transplant population. Up to this day, there are few studies gathered about how Low Microbial Diet effects immunocompromised patients. The studies that have been conducted may have the same subject matter of Low Microbial Diet but focus on different cancer populations. Periods of immunocompromised state were inconsistent in adult blood and marrow transplant patients which can pose another barrier in knowing the truth behind Low Microbial Diets’ efficacy.  Moreover, there is still scant evidence on the effectiveness of diet to adult blood and marrow transplant patients. Because of this review, liberalization of the Low Microbial Diet has been instituted at Stanford’s Department of Blood and Marrow Transplant in early 2012. Food choice offerings not only became of greater variety but less labor intensive and also more acceptable. Since implementation, there are only 3 unrelated lactobacillus infections to date at Stanford’s Department of Blood and Marrow Transplant.