Clostridioides difficile Infection in Hematology-Oncology Patients Receiving Bacterial Prophylaxis With Levofloxacin: A Single-Institution Experience
Abstract
Background and objectives Prophylactic levofloxacin reduces the risk of bacteremia in patients with treatment-induced neutropenia. However, fluoroquinolone use has been linked to an increased risk of Clostridioides difficile infections (CDI), which can be associated with delays in treatment schedules or prolonged hospital stays in hematology/oncology patients. Due to a lack of convincing evidence, routine CDI prophylactic interventions are not currently recommended. In this context, we aimed to assess how prophylactic levofloxacin in pediatric hematology-oncology patients affects CDI rates at our institution and whether there is a rationale for implementing CDI prophylactic measures in this population. Methods We conducted a retrospective chart review of prophylactic levofloxacin administration records in patients admitted to our pediatric hematology-oncology unit between January 2022 and June 2023. Only records documenting more than four days of continuous exposure to levofloxacin were included. Patients were excluded if levofloxacin was administered exclusively in the outpatient setting, if they did not have a primary hematologic or oncologic diagnosis, or if levofloxacin was administered for purposes other than antibacterial prophylaxis. Cases of CDI were identified as the presence of diarrhea with a positive stool C. difficile toxin A/B enzyme immunoassay or nucleic acid amplification test. CDIs that occurred within 30 days of documented levofloxacin exposure were then…
Read the paper
Related studies
- Ferulic acid regulates the AKT/GSK-3β/CRMP-2 signaling pathway in a middle cerebral artery occlusion animal model
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
- Photochemical behavior of levofloxacin
- Correlation Between Dissolution Profiles of Salt-Form Drugs in Biorelevant Bicarbonate Buffer and Oral Drug Absorption: Importance of Dose/ Fluid Volume Ratio
- Evaluation of the synergistic potential and mechanisms of action for de novo designed cationic antimicrobial peptides
- Synthesis of [11C]levofloxacin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.