Original Articles
Vol. 15 No. 1 (2023): Review Articles, Original Article, Scientific Letter, Case Reports Letter to the Editor
LEVOFLOXACIN PROPHYLAXIS VERSUS NO PROPHYLAXIS IN ACUTE MYELOID LEUKEMIA DURING POST-INDUCTION APLASIA: A SINGLE CENTER STUDY
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: January 21, 2023
Accepted: February 19, 2023
Accepted: February 19, 2023
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Background and objectives: acute myeloid leukemia (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). Methods: we performed a 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). Results: 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). Conclusions: levofloxacin prophylaxis omission 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. In the prophylaxis group we observed a higher incidence of FQ resistant organisms.
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How to Cite
“LEVOFLOXACIN PROPHYLAXIS VERSUS NO PROPHYLAXIS IN ACUTE MYELOID LEUKEMIA DURING POST-INDUCTION APLASIA: A SINGLE CENTER STUDY” (2023) Mediterranean Journal of Hematology and Infectious Diseases, 15(1), p. e2023022. doi:10.4084/MJHID.2023.022.
Copyright (c) 2023 Irene Urbino, Chiara Frairia, Alessandro Busca, Silvia Corcione, Stefano D'Ardia, Chiara Maria Dellacasa, Valentina Giai, Carolina Secreto, Roberto Freilone, Francesco Giuseppe De Rosa, Semra Aydin, Giovannino Ciccone, Rosalba Rosato, Marco Cerrano, Ernesta Audisio
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