Levofloxacin versus Cefpodoxime for Antibacterial Prophylaxis in Allogeneic Stem Cell Transplantation
| Autor: | Jason Yeh, Sairah Ahmed, Vi P Doan, Samuel L. Aitken, Ella J. Ariza-Heredia, Alison M. Gulbis |
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| Rok vydání: | 2019 |
| Předmět: |
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medicine.medical_specialty medicine.drug_class Antibiotics Levofloxacin Neutropenia Cefpodoxime Disease-Free Survival Drug Resistance Multiple Bacterial Internal medicine medicine Humans Antibiotic prophylaxis Gram-Positive Bacterial Infections Aged Retrospective Studies Clostridiales Transplantation business.industry Incidence (epidemiology) Ceftizoxime Hematopoietic Stem Cell Transplantation Hematology Middle Aged Allografts Antimicrobial medicine.disease Survival Rate Female Unrelated Donors business medicine.drug |
| Zdroj: | Biology of Blood and Marrow Transplantation. 25:1637-1641 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2019.04.013 |
| Popis: | National guidelines recommend antimicrobial prophylaxis for allogeneic stem cell transplant patients during the pre-engraftment period because of increased infection risk during neutropenia. Fluoroquinolones have demonstrated lower rates of bacteremias and incidence of neutropenic fever, but there is limited evidence in the use of alternative antibacterials such as cefpodoxime. The primary objective of this study is to compare the rates of antibiotic prophylaxis failure between levofloxacin and cefpodoxime in allogeneic stem cell transplant recipients. Secondary objectives include comparing and characterizing number and type of infections, mortality at day 100 post-transplant, and hospitalizations for infectious causes in the first 100 days of transplant. This is a single-center, retrospective chart review of adult patients who received an allogeneic stem cell transplant from matched related and matched unrelated donors and antibacterial prophylaxis with levofloxacin or cefpodoxime from January 1, 2011, to October 1, 2014. A total of 142 patients were evaluated (71 levofloxacin, 71 cefpodoxime). Both levofloxacin and cefpodoxime groups had similar rates of neutropenic fever and antibiotic prophylaxis failure (58% versus 58%, P = NS). There were similar incidences of Clostridioides difficile and Multi-drug resistant (MDR) infections among both levofloxacin and cefpodoxime groups. Rates of infections, hospitalizations, and mortality in the first 100 days were similar among both groups. Cefpodoxime can be used as an alternative to levofloxacin for antibiotic prophylaxis in allogeneic stem cell transplant patients. |
| Databáze: | OpenAIRE |
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