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Antibacterial prophylaxis after chemotherapy for solid tumors and lymphomas
Michael Cullen1, Neil Steven, Lucinda Billingham
1University Hospital Birmingham Cancer Centre, Birmingham, United Kingdom. michael.cullen@uhb.nhs.uk
The New England Journal of Medicine
|September 9, 2005
Summary
Prophylactic levofloxacin significantly reduced febrile episodes and infections in patients undergoing chemotherapy for solid tumors or lymphoma. This antibiotic use decreased hospitalization rates, offering a potential benefit in managing chemotherapy-induced neutropenia.
Area of Science:
- Oncology
- Infectious Diseases
- Clinical Pharmacology
Background:
- The use of prophylactic antibiotics during chemotherapy is debated.
- Patients undergoing chemotherapy for solid tumors or lymphoma are at risk of neutropenia.
Purpose of the Study:
- To evaluate the efficacy of prophylactic levofloxacin in reducing febrile episodes and infections in chemotherapy patients.
- To assess the impact of levofloxacin on hospitalization rates due to infection.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted.
- 1565 patients receiving chemotherapy for solid tumors or lymphoma were enrolled.
- Patients received either levofloxacin or placebo during neutropenic periods.
Main Results:
- Levofloxacin significantly reduced febrile episodes during the first cycle (3.5% vs 7.9%) and entire course (10.8% vs 15.2%).
- Probable infections (34.2% vs 41.5%) and hospitalizations (15.7% vs 21.6%) were lower in the levofloxacin group.
- Rates of severe infection and infection-related deaths were similar between groups.
Conclusions:
- Prophylactic levofloxacin is effective in decreasing fever, probable infections, and hospitalizations in patients with solid tumors or lymphoma undergoing chemotherapy.
- The study supports the use of levofloxacin for infection prevention in this patient population.
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