title: Retrospective analysis of fluoroquinolone prophylaxis in patients undergoing allogeneic hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Patients undergoing allogeneic hematopoietic stem cell transplant are at a high risk for infection-related mortality in the immediate post-transplantation phase. Prophylaxis with a fluoroquinolone is now recommended to reduce this risk with the stipulation that surveillance for increased fluoroquinolone resistance Clostridium difficile associated diarrhea be conducted.
  
  
  METHODS
  We conducted a retrospective chart review of 48 patients who underwent an allogeneic hematopoietic stem cell transplant and received a fluoroquinolone for prophylaxis and 48 patients who underwent an allogeneic hematopoietic stem cell transplant who did not receive a fluoroquinolone for prophylaxis. All patients received the same standard antifungal, antiviral and anti-pneumocystis prophylaxis.
  
  
  RESULTS
  Patients receiving fluoroquinolone prophylaxis had a lower incidence of febrile neutropenia than those not receiving prophylaxis, though the difference was not found to be statistically significant (83% vs. 67%, p = 0.098). Similar non-significant improvements in the number of positive cultures recovered during an episode of febrile neutropenia and antimicrobial days were noted. No significant increase in fluoroquinolone resistance, Clostridium difficile associated diarrhea, or in methicillin resistant Staphylococcus aureus infections were noted.
  
  
  CONCLUSIONS
  Our single institution experience with fluoroquinolone prophylaxis for allogeneic hematopoietic stem cell transplant patients supports continuation of this practice. Expansion to autologous hematopoietic stem cell transplant patients may be appropriate based on guideline recommendations and our institution-specific experience with fluoroquinolone prophylaxis.
authors.affiliation: Department of Pharmacy, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Simondsen
authors.forename: Michael P
authors.initials: MP
authors.lastname: Reed
authors.forename: Mary S
authors.initials: MS
authors.lastname: Mably
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhang
authors.forename: Walter L
authors.initials: WL
authors.lastname: Longo
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000379:methods*; D016360:Clostridioides difficile / Q000302:isolation & purification; D003015:Clostridium Infections / Q000453:epidemiology / Q000517:prevention & control; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000517:prevention & control; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D009503:Neutropenia / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control; D014184:Transplantation, Homologous
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D024841:Fluoroquinolones