Hematopoietic Stem Cell Transplant Recipients Colonized with Fluoroquinolone-Resistant Enterobacteriaceae at High Risk for Bacteremia

Levofloxacin prophylaxis may actually increase the risk for bacteremia in colonized patients.

Although fluoroquinolone prophylaxis is recommended during the period of neutropenia for most patients undergoing hematopoietic stem cell transplant (HSCT), increased rates of fluoroquinolone-resistant Enterobacteriaceae may limit the effectiveness of this intervention (NEJM JW Infect Dis Jan 2019 and J Clin Oncology 36:3043). Now, investigators have assessed outcomes in 312 HSCT recipients who received levofloxacin prophylaxis beginning 1 day before transplant.

Perianal swabs were obtained at admission and then weekly. Thirty-one patients (10%) were colonized with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) at baseline; 25% of these organisms were sensitive to levofloxacin. Ten patients with baseline ESBL-E colonizat…

Reviewing Author

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Hematopoietic Stem Cell Transplant Recipients Colonized with Fluoroquinolone-Resistant Enterobacteriaceae at High Risk for Bacteremia

Topics

Reviewing Author