Safety and Efficacy of Prophylactic Levofloxacin in Pediatric and Adult Hematopoietic Stem Cell Transplantation Patients
Abstract
BACKGROUND
Levofloxacin has been widely used for bacteremia prophylaxis in the pre-engraftment setting for patients undergoing hematopoietic stem cell transplant (HSCT), but data supporting this practice are inconsistent. In addition to concern for lack of benefit, there are also concerns that this practice could increase the rates of Clostridioides difficile (C. diff) infections, the incidence of multidrug-resistant organisms (MDRO) or lead to increased incidence of acute graft versus host disease (aGVHD) by disrupting the gut microbiome. This study aims to assess the safety and efficacy of levofloxacin as bacterial prophylaxis in pediatric and young adult patients undergoing allogeneic or autologous HSCT at a single pediatric center.
OBJECTIVE
To determine the safety and efficacy of levofloxacin as bacterial prophylaxis in patients undergoing HSCT.
STUDY DESIGN
We conducted a retrospective chart review evaluating patients six months of age and older who received an HSCT at our center between January 1, 2016, and July 31, 2020. Patients transplanted before March 2018 did not receive levofloxacin prophylaxis while patients transplanted from April 2018 did receive prophylaxis. Each transplant was included as a separate episode if patients received more than one transplant during the inclusion time. The primary outcome of this study was the proportion of patients who experienced at least one bacterial bloodstream infection (BSI) in the first 100 days post-transplant. Secondary…
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