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Inicio Medicina Clínica (English Edition) Comparative study on the usefulness of antibacterial prophylaxis with levofloxac...
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Vol. 146. Issue 1.
Pages 16-19 (January 2016)
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Vol. 146. Issue 1.
Pages 16-19 (January 2016)
Brief report
Comparative study on the usefulness of antibacterial prophylaxis with levofloxacin in patients submitted to hematopoietic stem cell transplantation
Estudio comparativo sobre la utilidad de la profilaxis antibacteriana con levofloxacino en pacientes receptores de un trasplante de progenitores hematopoyéticos
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Jesús Fernandez Sojoa,
Corresponding author
jfernandez_sojo@hotmail.com

Corresponding author.
, Montserrat Batlle Massanaa, Mireia Morgadesa, Susana Vives Poloa, María Dolores Quesadab, Josep María Ribera Santasusanaa
a Servicio de Hematología Clínica, Institut Català d’Oncologia-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
b Servicio de Microbiología, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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Table 1. Comparison of the clinical characteristics, type of blood disorder and characteristics of hematopoietic stem cell transplantation in the 2 study groups.
Table 2. Comparison of key clinical and microbiological variables based on the use or prophylactic levofloxacin or lack of it.
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Abstract
Background

Bacterial infection remains a frequent complication in patients receiving a hematopoietic stem cell transplantation (HSCT). However, the impact of the antibacterial prophylaxis mortality in these patients is controversial.

Patients and methods

Retrospective comparison of 2 consecutive groups of patients undergoing HSCT receiving (n=132) or not (n=107) antibacterial prophylaxis with levofloxacin.

Results

41% of patients receiving prophylaxis with levofloxacin had microbiologically documented infection (MDI) with bacteremia, compared with 40% of those not receiving levofloxacin. The frequency of gram-negative bacteremia was 11 and 38%, the resistance to levofloxacin was 39 and 14%, and the mortality was 8 and 7%, respectively.

Conclusions

In our experience, the use of levofloxacin as prophylaxis in HSCT was associated with a lower frequency of gram-negative bacteremia but was not associated with a decreased rate of MDI and did not influence their outcome. In contrast, there was an increase in quinolone resistance in patients treated with levofloxacin.

Keywords:
Prophylaxis
Hematopoietic stem cell transplant
Levofloxacin
Bacteremia
Resistance
Resumen
Fundamento

La infección bacteriana continúa siendo una complicación frecuente en pacientes receptores de un trasplante de progenitores hematopoyéticos (TPH). No obstante, el impacto de la profilaxis antibacteriana en la mortalidad de estos pacientes es controvertido.

Pacientes y métodos

Comparación retrospectiva de 2 grupos consecutivos de receptores de TPH según recibieran (n=132) o no (n=107) profilaxis antibacteriana con levofloxacino.

Resultados

En el 41% de los procedimientos de TPH en los que se administró profilaxis con levofloxacino se constató infección microbiológicamente documentada (IMD) con bacteriemia, frente a un 40% de los que no recibieron levofloxacino. La frecuencia de bacteriemia por bacilos gramnegativos fue del 11 y del 38%, la resistencia a levofloxacino fue del 39 y del 14%, y hubo un 8 y 7% de muertes, respectivamente.

Conclusiones

En nuestra experiencia, el uso de levofloxacino se asoció a una menor frecuencia de bacteriemia por microorganismos gramnegativos, pero no se asoció a disminución en la tasa de IMD ni influyó en su evolución. En cambio, hubo un aumento de la resistencia a quinolonas en los pacientes tratados con levofloxacino.

Palabras clave:
Profilaxis
Trasplante de progenitores hematopoyéticos
Levofloxacino
Bacteriemia
Resistencia

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