Clinical and Microbiologic Outcomes of Quinolone Prophylaxis in Children With Acute Myeloid Leukemia

Abstract

CPx neither alter the incidence of overall bacteremia nor change the pattern of fever or use of supportive care. Our experience supports further investigation into the use of extended-spectrum quinolone prophylaxis during therapy for pediatric AML.

Infectious Complications in Children With Acute Myeloid Leukemia and Down Syndrome: Analysis of the Prospective Multicenter Trial AML‐BFM 2004

“…It remains unclear whether these differences are due to different supportive care strategies or to other factors. In this regard, it was recently reported that quinolone prophylaxis significantly increased the incidence of VGS bacteremia in children with AML . An interim survey on supportive care strategies in children with AML revealed that about one‐third of the centers that participated in the study AML‐BFM 2004 administered antibacterial prophylaxis, although in most cases with penicillin …”

Prophylactic levofloxacin in pediatric neutropenic patients during autologous hematopoietic stem cell transplantation

“…A pilot study of ciprofloxacin prophylaxis for pediatric patients receiving delayed intensification therapy for acute lymphoblastic leukemia showed a significant reduction in hospitalization, intensive care admission, and bacteremia compared to historical controls . In another study in acute myeloid leukemia pediatric patients, the only benefit of fluoroquinolone prophylaxis was the reduction in gram‐negative bacteremia .…”

Risk factors for and prevention of bloodstream infection in pediatric AML—The debate continues

“…Current concepts of prophylactic antibiotics to prevent BSIs due to VGS and/or Enterobacteriaceae in pediatric patients with AML rely on retrospective observational or single‐center cohort studies . Oral penicillin will not be effective if more than 20% of all VGS display in vitro resistance to penicillin.…”

“…Felsenstein et al . examined the effectiveness of ciprofloxacin prophylaxis in pediatric patients with AML in a retrospective chart review.…”

“…On multivariable analysis, the presence or the type of the central venous catheter and the use of total parenteral nutrition did not influence the risk of BSI. In contrast, diarrhea, receipt of blood products in preceding 4-7 days, not receiving antibiotics, and chemotherapy cycle were strong and independent pre- Current concepts of prophylactic antibiotics to prevent BSIs due to VGS and/or Enterobacteriaceae in pediatric patients with AML rely on retrospective observational [5][6][7] or single-center cohort studies. 8,9 Oral penicillin will not be effective if more than 20% of all VGS display in vitro resistance to penicillin.…”