The impact of levofloxacin prophylaxis on empiric intravenous antibiotic use in pediatric hematopoietic stem cell transplant recipients

Pediatr Blood Cancer. 2024 Aug;71(8):e31059. doi: 10.1002/pbc.31059. Epub 2024 May 9.

Abstract

Levofloxacin prophylaxis during periods of neutropenia in pediatric hematopoietic stem cell transplant (HSCT) may reduce the number of febrile episodes and use of empiric intravenous antibiotics (EIA); however, the literature is conflicting. This retrospective review compared EIA use before and after implementation of levofloxacin prophylaxis at a children's hospital. Levofloxacin prophylaxis was associated with reduced use of certain EIA; however, did not reduce the number of positive blood cultures or clinical deteriorations. Therefore, levofloxacin prophylaxis may have implications for the stewardship of broad-spectrum intravenous antibiotics used in pediatric HSCT.

Keywords: antimicrobial stewardship; hematopoietic stem cell transplant; levofloxacin; pediatrics; prophylaxis.

MeSH terms

  • Administration, Intravenous
  • Adolescent
  • Anti-Bacterial Agents* / administration & dosage
  • Anti-Bacterial Agents* / therapeutic use
  • Antibiotic Prophylaxis* / methods
  • Child
  • Child, Preschool
  • Female
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Infant
  • Levofloxacin* / administration & dosage
  • Levofloxacin* / therapeutic use
  • Male
  • Neutropenia / chemically induced
  • Neutropenia / prevention & control
  • Retrospective Studies

Substances

  • Levofloxacin
  • Anti-Bacterial Agents