TY - JOUR AU - Urbino, Irene AU - Frairia, Chiara AU - Busca, Alessandro AU - Corcione, Silvia AU - D'Ardia, Stefano AU - Dellacasa, Chiara Maria AU - Giai, Valentina AU - Secreto, Carolina AU - Freilone, Roberto AU - De Rosa, Francesco Giuseppe AU - Aydin, Semra AU - Ciccone, Giovannino AU - Rosato, Rosalba AU - Cerrano, Marco AU - Audisio, Ernesta PY - 2023/02/28 Y2 - 2024/03/29 TI - LEVOFLOXACIN PROPHYLAXIS VERSUS NO PROPHYLAXIS IN ACUTE MYELOID LEUKEMIA DURING POST-INDUCTION APLASIA: A SINGLE CENTER STUDY JF - Mediterranean Journal of Hematology and Infectious Diseases JA - Mediterr J Hematol Infect Dis VL - 15 IS - 1 SE - Original Articles DO - 10.4084/MJHID.2023.022 UR - https://www.mjhid.org/mjhid/article/view/5258 SP - e2023022 AB - <div><p><strong><span lang="EN-US">Background and objectives: </span></strong><span lang="EN-US">acute myeloid leukemia</span> <span lang="EN-US">(</span><span lang="EN-US">AML) patients are at high risk of infections during post induction neutropenia. Recently, the role of antibacterial prophylaxis has been reconsidered due to concerns about the emergence of multi-resistant pathogens. Aim of the present study was to evaluate the impact of prophylaxis omission on the rate of induction death (primary endpoint), neutropenic fevers, bloodstream infections (BSIs), resistant pathogens BSIs and septic shocks (secondary endpoints).&nbsp;</span><strong><span lang="EN-US">Methods:&nbsp; </span></strong><span lang="EN-US">we performed a</span> <span lang="EN-US">retrospective single center study including 373 AML patients treated with intensive induction chemotherapy, divided in two groups according to levofloxacin prophylaxis given (group A, gA) or not (group B, gB).&nbsp;</span><strong><span lang="EN-US">Results: </span></strong><span lang="EN-US">neutropenic fever was observed in 91% of patients in gA and 97% in gB (OR 0.35, IC95% 0.08 – 1.52, p=0162).The rate of BSIs was 27% in gA compared to 34% in gB (OR 0.69, 0.38 – 1.25, p=0.222). Induction death rate was 5% in gA and 3% in gB (OR 1.50, 0.34 – 6.70, p=0.284). Fluoroquinolones (FQ) resistant pathogens were responsible for 59% of total BSIs in gA and 22% in gB (OR 5.07, 1.87 – 13.73, p=0.001); gram-negative BSIs due to multi-drug resistant organisms were 31% in gA and 36% in gB (OR 0.75, 0.15 – 3.70, p=0.727).&nbsp;</span><strong><span lang="EN-US">Conclusions: </span></strong><span lang="EN-US">levofloxacin prophylaxis omission </span><span lang="EN-US">was not associated with an increased risk of induction death. Cumulative incidence of neutropenic fever was higher in non-prophylaxis group, while no difference was observed for BSIs. </span><span lang="EN-US">In the prophylaxis group we observed a higher incidence of </span><span lang="EN-US">FQ resistant organisms.</span></p></div> ER -