title: Effect of levofloxacin prophylaxis for prevention of severe infections in multiple myeloma patients receiving bortezomib-containing regimens.
abstract: Fluoroquinolone is recommended as a prophylactic antibiotic for high-risk patients with profound neutropenia. We previously reported that multiple myeloma (MM) patients who received bortezomib-based regimens were at higher risk of severe infections (30.9%) associated with lymphocytopenia. In the study, we evaluated whether severe infectious complications can be prevented by prophylactic administration of oral levofloxacin in MM patients treated with bortezomib-based regimens. A total of 80 patients received oral levofloxacin 500 mg daily during the median four cycles of treatment. The prophylactic group (n = 80) with levofloxacin showed significantly decreased severe infections compared to a historical control group (n = 139) without levofloxacin prophylaxis during treatment of bortezomib-based regimens (17.5 vs. 30.9%, P = 0.037). In the prophylactic group, two patients (2.5%) died of pneumonia and septic shock. Four patients (5%) stopped levofloxacin due to side effects that consisted of gastrointestinal discomfort (2.5%), itching sense (1.25%), and QTc prolongation (1.25%). In conclusion, prophylaxis with levofloxacin may be effective in the prevention of severe infection in MM patients receiving bortezomib-based regimens. A prospective randomized study is needed to test the prophylactic effect of levofloxacin in MM patients treated with bortezomib-based regimens.
authors.affiliation: Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, 322 Seoyangro, Hwasun, Jeollanamdo, 519-763, Republic of Korea.
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Jung
authors.forename: Seung-Ji
authors.initials: SJ
authors.lastname: Kang
authors.forename: Hee-Chang
authors.initials: HC
authors.lastname: Jang
authors.forename: Jae-Sook
authors.initials: JS
authors.lastname: Ahn
authors.forename: Deok-Hwan
authors.initials: DH
authors.lastname: Yang
authors.forename: Seung-Shin
authors.initials: SS
authors.lastname: Lee
authors.forename: Yeo-Kyeoung
authors.initials: YK
authors.lastname: Kim
authors.forename: Hyeoung-Joon
authors.initials: HJ
authors.lastname: Kim
authors.forename: Je-Jung
authors.initials: JJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007239:Infections / Q000188:drug therapy* / Q000209:etiology* / Q000382:microbiology; D064704:Levofloxacin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy; D011719:Pyrazines / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D000970:Antineoplastic Agents; D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D064704:Levofloxacin