title: Prophylactic levofloxacin in pediatric neutropenic patients during autologous hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Using fluoroquinolone prophylaxis in pediatric neutropenic patients is a controversial issue due to the concern about emergence of resistant strains in addition to the lack of pediatric studies. This study was performed to assess the effectiveness of levofloxacin prophylaxis in pediatric patients during autologous stem cell transplantation.
  
  
  METHODS
  This was an observational study of pediatric patients who underwent autologous stem cell transplantation, comparing patients who received levofloxacin prophylaxis to historical controls.
  
  
  RESULTS
  A total of 96 patients were included (46 patients in the control group and 50 patients received levofloxacin). The median duration till onset of first fever was 11 d in the control group as compared to 15 d in patients who received levofloxacin (p ≤ 0.001). The incidence of infectious complications was higher in patients without levofloxacin (4/46) than those with levofloxacin (1/50). The median duration of empirical antibiotic use was 10 d in the levofloxacin group compared with 14 d in the control group (p < 0.001).
  
  
  CONCLUSIONS
  Levofloxacin prophylaxis delayed first spike of fever, decreased the incidence of septic complications, and shortened the duration of empiric antibiotic use, but its impact on emergence of resistant organisms should be closely monitored.
authors.affiliation: Pediatric Hematology/Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.|Pediatric Hematology/Oncology, Children Cancer Hospital Egypt 57357, Cairo, Egypt.
authors.forename: Hanafy Ahmed
authors.initials: HA
authors.lastname: Hafez
authors.affiliation: Clinical Pharmacy, Children Cancer Hospital 57357, Cairo, Egypt.
authors.forename: Dalia
authors.initials: D
authors.lastname: Yousif
authors.affiliation: Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
authors.forename: Maggie
authors.initials: M
authors.lastname: Abbassi
authors.affiliation: Pediatric Hematology/Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Elborai
authors.affiliation: Pediatric Hematology/Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.|Pediatric Hematology/Oncology, Children Cancer Hospital Egypt 57357, Cairo, Egypt.
authors.forename: Alaa
authors.initials: A
authors.lastname: Elhaddad
mesh_terms: D000293:Adolescent; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D064147:Febrile Neutropenia / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D064704:Levofloxacin / Q000627:therapeutic use*; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D014182:Transplantation, Autologous
chemical_list: D064704:Levofloxacin
keywords: antibacterial prophylaxis; autologous; levofloxacin; stem cell transplantation