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Acta Medica Colombiana
versão impressa ISSN 0120-2448
Resumo
OSUNA, Monica; CASAS, Claudia Patricia; GOMEZ, Carlos Hernando e ALBA, Magda Jeannette. Clinical impact of levofloxacin prophylaxis in neutropenic patients with hematological malignancies Before and after study in a fourth-level Colombian hospital. Acta Med Colomb [online]. 2016, vol.41, n.4, pp.235-242. ISSN 0120-2448.
Introduction:
the use of fluoroquinolone prophylaxis in patients with neutropenia and hematological malignancies is controversial. A positive impact on reducing morbidity and mortality has been reported, but the subsequent development of bacterial resistance is a concern.
Objective:
to compare the incidence of febrile neutropenia, documented infection and death from infection in a cohort of adult patients with hematolymphoid neoplasms on high-risk chemotherapy that receive prophylaxis with levofloxacin versus those who did not receive prophylaxis.
Material and methods:
a before and after study was performed. Outcomes were febrile neutropenia, clinically and microbiologically documented infection, duration of hospitalization, intensive care unit stay, and mortality associated with infection.
Results:
one hundred sixty-eight (168) hospital admissions, 98 in the levofloxacin group and 70 in the non-prophylaxis group. The levofloxacin group had a reduction in febrile neutropenia events (39 vs 70%, p = <0.001), a lower rate of microbiologically documented infections (45.6 vs 61.2%, p = 0.049), shorter hospital stay (24 vs. 28.1 days , P = 0.008), and shorter stay in the intensive care unit (17 vs 6.1%, p = 0.023) compared to the group without prophylaxis. Association in the administration of levofloxacin and reduction of febrile neutropenia events OR = 0.21 (95% CI 0.10-0.43), NNT = 3 (95% CI 2-6) was found. There was no documented difference in mortality (3 vs 8.6%, p = 0.118).
Conclusions:
prophylaxis showed benefit in reducing febrile events, microbiologically documented infection, less hospital and intensive care unit stay, with no impact on mortality. (Acta Med Colomb 2016; 40: 235-242).
Palavras-chave : antibiotic prophylaxis; levofloxacin; hematological neoplasias; febrile neutropenia induced by chemotherapy; hospital mortality.