Faculty Collaboration Database

Retrospective analysis of fluoroquinolone prophylaxis in patients undergoing allogeneic hematopoietic stem cell transplantation. J Oncol Pharm Pract 2013 Dec;19(4):291-7

Date

11/28/2012

Pubmed ID

23184539

DOI

10.1177/1078155212465215

Scopus ID

2-s2.0-84888095731 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

BACKGROUND: Patients undergoing allogeneic hematopoietic stem cell transplant are at a high risk for infection-related mortality in the immediate post-transplantation phase. Prophylaxis with a fluoroquinolone is now recommended to reduce this risk with the stipulation that surveillance for increased fluoroquinolone resistance Clostridium difficile associated diarrhea be conducted.

METHODS: We conducted a retrospective chart review of 48 patients who underwent an allogeneic hematopoietic stem cell transplant and received a fluoroquinolone for prophylaxis and 48 patients who underwent an allogeneic hematopoietic stem cell transplant who did not receive a fluoroquinolone for prophylaxis. All patients received the same standard antifungal, antiviral and anti-pneumocystis prophylaxis.

RESULTS: Patients receiving fluoroquinolone prophylaxis had a lower incidence of febrile neutropenia than those not receiving prophylaxis, though the difference was not found to be statistically significant (83% vs. 67%, p = 0.098). Similar non-significant improvements in the number of positive cultures recovered during an episode of febrile neutropenia and antimicrobial days were noted. No significant increase in fluoroquinolone resistance, Clostridium difficile associated diarrhea, or in methicillin resistant Staphylococcus aureus infections were noted.

CONCLUSION: Our single institution experience with fluoroquinolone prophylaxis for allogeneic hematopoietic stem cell transplant patients supports continuation of this practice. Expansion to autologous hematopoietic stem cell transplant patients may be appropriate based on guideline recommendations and our institution-specific experience with fluoroquinolone prophylaxis.

Author List

Simondsen KA, Reed MP, Mably MS, Zhang Y, Longo WL

Author

Walter L. Longo MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Anti-Bacterial Agents
Anti-Infective Agents
Antibiotic Prophylaxis
Clostridium Infections
Diarrhea
Female
Fever
Fluoroquinolones
Hematopoietic Stem Cell Transplantation
Humans
Incidence
Male
Methicillin-Resistant Staphylococcus aureus
Middle Aged
Neutropenia
Retrospective Studies
Staphylococcal Infections
Transplantation, Homologous