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. 2017 Aug;25(8):2593-2601.
doi: 10.1007/s00520-017-3670-3. Epub 2017 Apr 2.

Fluoroquinolone prophylaxis in autologous hematopoietic stem cell transplant recipients

Dipenkumar Modi  1 , Hyejeong Jang  2 , Seongho Kim  2 , Malini Surapaneni  3 , Kamya Sankar  4 , Abhinav Deol  5 , Lois Ayash  5 , Divaya Bhutani  5 , Lawrence G Lum  6 , Voravit Ratanatharathorn  5 , Richard Manasa  7 , Kendra Mellert  7 , Pranatharthi Chandrasekar  8 , Joseph P Uberti  5
Affiliations

Fluoroquinolone prophylaxis in autologous hematopoietic stem cell transplant recipients

Dipenkumar Modi et al. Support Care Cancer. 2017 Aug.

Abstract

Purpose: Although fluoroquinolone prophylaxis is frequently utilized in autologous hematopoietic stem cell transplant (AHSCT) patients, its impact on morbidity and mortality is uncertain. This study investigates the role of quinolone prophylaxis after AHSCT in recent years.

Methods: We conducted a retrospective review of 291 consecutive adult patients who underwent AHSCT for malignant disorders, between June 2013 and January 2015. Outcomes were compared between patients who received norfloxacin prophylaxis and those who did not. The endpoints were mortality during prophylaxis and at 100 days after transplant, frequency of ICU admissions, and incidence and type of bacteremia.

Results: Of 291 patients, 252 patients received norfloxacin prophylaxis and 39 patients did not. The mortality during prophylaxis and at 100 days as well as the median number of days of hospitalization following AHSCT did not differ between the two groups. No differences were noted in the frequency of ICU admission, incidence of septic shock, and duration of ICU stay. Patients who did not receive prophylaxis had a significantly higher rate of neutropenic fever (97%) than patients who received prophylaxis (77%) (p = 0.005). The patients with prophylaxis demonstrated a significantly higher rate of gram-positive bacteremia as compared to those without prophylaxis (p = 0.002). Frequency of Clostridium difficile infection was similar during and post-prophylaxis. More antibiotic use was noted among patients without prophylaxis [97%; median 9 (range, 5-24) days] compared to patients with prophylaxis [79%; median 7 (range, 3-36) days, p = 0.04].

Conclusion: Although fluoroquinolone prophylaxis reduced the incidence of neutropenic fever and antibiotic use in AHSCT, it did not alter mortality or morbidity.

Keywords: Autologous stem cell transplant; Fluoroquinolone prophylaxis; Infection prophylaxis; Length of stay and ICU admission; Neutropenic fever.

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Conflict of interest statement

Conflict of interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The neutropenic fever-free survival after autologous hematopoietic stem cell transplant comparing without prophylaxis vs. with prophylaxis group
See this image and copyright information in PMC

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