Current Approaches to Neutropenic Diet

Year 2018, , 87 - 94, 11.02.2018

Cansu Bekar , Aylin Açıkgöz

https://doi.org/10.17681/hsp.337041

Abstract

The absolute neutrophil count of less than 1500 cells/mm³ is
associated with increased risk of infection. Many protective measures are being
taken to prevent infections caused by neutropenia because of treatments such as
chemotherapy, radiotherapy, hematopoietic stem cell transplantation. The
neutropenic diet is based on preventing bacterial and fungal contamination and
eliminating colonizing microorganisms in the gastrointestinal tract to prevent
infections caused by foodborne pathogens. The most common questions about this
diet model are when to start, when to terminate, which foods to contain, and to
which group of patients it is more effective. Although there seems to be no
consensus among establishments, it is known that the most restricted foods are
raw and undercooked eggs, meat, poultry and seafood and unpasteurized milk and
dairy products. However, there are also considerations that it is more
important to base nutritional safety than restrictive diet approaches because
the results of the study cannot prove the superiority of the neutropenic diet.
These approaches have great importance to this patients since food hygiene
cannot be achieved at the desired level in undeveloped and developing
countries. It is considered necessary that the proposals including the national
or international agreed approaches should be put into practice with the common
guidelines that organizations can be used. In this review, it is aimed to
examine the content of the neutropenic diet and its use in the light of current
literature.

Keywords

Oncology, neutropenia

Nötropenik Diyette Güncel Yaklaşımlar / Current Approaches to Neutropenic Diet

Abstract

Mutlak nötrofil sayısının 1500
hücre/mm³’ün altında olması, artmış enfeksiyon riski ile
ilişkilendirilmektedir. Kemoterapi, radyoterapi, hematopoetik kök hücre nakli
gibi tedaviler sonucu gelişebilen nötropeninin neden olduğu enfeksiyonların
engellenmesi için birçok koruyucu önlem alınmaktadır. Nötropenik diyet, gıda
kaynaklı patojenlerin neden olabileceği enfeksiyonları önlemek için, bakteri ve
mantar bulaşmalarını önlemeyi ve gastrointestinal sistemi kolonize eden
mikroorganizmaları elimine etmeyi temel alır. Bu diyet modeliyle ilgili en çok
karşılaşılan sorular; diyete ne zaman başlanılacağı, ne zaman sonlandırılacağı,
hangi besinleri içereceği ve hangi hasta grubunda daha etkili olduğuna
yöneliktir. Kuruluşlar arasında bir uzlaşım yok gibi görünse de en çok
kısıtlanan besinlerin çiğ veya az pişmiş yumurta, et, tavuk ve deniz ürünleri
ile pastörize edilmemiş süt ve süt ürünleri olduğu bilinmektedir. Ancak çalışma
sonuçlarının nötropenik diyetin üstünlüğünü kanıtlayamaması nedeniyle
kısıtlayıcı diyet yaklaşımları yerine besin güvenlinin temel alınmasının daha
önemli olduğu düşünceleri de mevcuttur. Gelişmemiş ve gelişmekte olan ülkelerde
besin hijyeninin istenilen ölçüde sağlanamaması nedeniyle bu yaklaşımlar hastalar
için büyük önem taşımaktadır. Bu nedenle ulusal ya da uluslararası ortak
yaklaşımları içeren önerilerin, kuruluşların kullanabileceği ortak kılavuzlar
ile uygulamaya sunulmasının gerekli olduğu düşünülmektedir.

Keywords

onkoloji, nötropeni, nötropenik diyet

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