Ciprofloxacin Reduces Occurrence of Fever in Children With Acute Leukemia who Develop Neutropenia During Chemotherapy

Laoprasopwattana, Kamolwish; Khwanna, Thida; Suwankeeree, Pussayaban; Sujjanunt, Tipwan; Tunyapanit, Wanutsanun; Chelae, Sureerat

doi:10.1097/inf.0b013e3182793610

Cited by 45 publications

(50 citation statements)

References 20 publications

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“…Only two studies were prospective, randomized, placebo-controlled, and enrolled a total of 262 patients. 3,12 In spite of the dif- Is the prophylaxis effective (low or high NNT)? An answer "yes" (low NNT) is in favor of prophylaxis and a "no" (high NNT) against.…”

Section: Main Effects Of Prophylaxismentioning

confidence: 99%

Antibiotic prophylaxis in neutropenic children with acute leukemia: Do the presently available data really support this practice?

Calitri

Ruberto

Castagnola

2018

European J of Haematology

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Antibiotics are frequently administered for prophylaxis of fever in neutropenic children with cancer. This strategy is mainly derived from adults' data, and various pediatric studies evidenced the effectiveness of antibiotics (eg, fluoroquinolones) in the prevention of febrile neutropenia. However, only two pediatric randomized, doubleblind, placebo-controlled trials have been performed, with a total of 262 leukemic children enrolled, and no other one was ever powered for analyzing effectiveness over other infectious complications. In an era of increasing antibiotic resistance, the widespread use of antibiotic prophylaxis in neutropenic leukemic children needs to be strongly supported. K E Y W O R D Sacute leukemia, antibiotic prophylaxis, febrile neutropenia, pediatrics

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Section: Main Effects Of Prophylaxismentioning

confidence: 99%

Antibiotic prophylaxis in neutropenic children with acute leukemia: Do the presently available data really support this practice?

Calitri

Ruberto

Castagnola

2018

European J of Haematology

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“…33 Data on bacterial prophylaxis in high-risk oncology patients are limited in children, but preliminary studies suggest that it may reduce the incidence of Gram-negative bacteremia. 34 Concurrently, prolonged use of fluoroquinolone prophylaxis may propose a significant risk for development of resistant bacterial strains in this population.…”

Section: Clinical Use Of Fluoroquinolones In Pediatric Practicementioning

confidence: 99%

“…32 Oral fluoroquinolones have been introduced as an attractive option for low-risk patients for preventing fever in the presence of neutropenia due to their ease of administration, high bioavailability, and broad Gramnegative spectrum. 33 Data on bacterial prophylaxis in high-risk oncology patients are limited in children, but preliminary studies suggest that it may reduce the incidence of Gram-negative bacteremia. 34 Concurrently, prolonged use of fluoroquinolone prophylaxis may propose a significant risk for development of resistant bacterial strains in this population.…”

Section: Clinical Use Of Fluoroquinolones In Pediatric Practicementioning

confidence: 99%

Safety Concerns Surrounding Quinolone Use in Children

Patel

Goldman

2016

The Journal of Clinical Pharma

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Fluoroquinolones are highly effective antibiotics with many desirable pharmacokinetic and pharmacodynamic properties including high bioavailability, large volume of distribution, and a broad spectrum of antimicrobial activity. Despite their attractive profile as anti-infective agents, their use in children is limited, primarily due to safety concerns. In this review we highlight the pharmacological properties of fluoroquinolones and describe their current use in pediatrics. In addition, we provide a comprehensive assessment of the safety data associated with fluoroquinolone use in children. Although permanent or destructive arthropathy remains a significant concern, currently available data demonstrate that arthralgia and arthropathy are relatively uncommon in children and resolve following cessation of fluoroquinolone exposure without resulting in long-term sequelae. The concern for safety and risk of adverse events associated with pediatric fluoroquinolone use is likely driving the limited prescribing of this drug class in pediatrics. However, in adults, fluoroquinolones are the most commonly prescribed broad-spectrum antibiotics, resulting in the development of drug-resistant bacteria that can be challenging to treat effectively. The consequence of misuse and overuse of fluoroquinolones leading to drug resistance is a greater, but frequently overlooked, safety concern that applies to both children and adults and one that should be considered at the point of prescribing.

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“…Indeed, only in one recent randomized clinical trial of antibiotic prophylaxis for febrile neutropenia in children the risk of selection of resistant strains during antibacterial prophylaxis was addressed in a satisfactory way with evaluation of intestinal flora colonizing the patients before and after the administration of prophylaxis. 6 …”

Section: Commentsmentioning

confidence: 99%

“…4,6 In the first one, the administration of amoxicillin-clavulanate significantly reduced, –21%, the incidence of fever in neutropenic children with acute leukemia/lymphoma, while no effect could be demonstrated in solid tumors. In the second one performed in acute leukemia, administration of ciprofloxacin determined a 23% reduction of febrile episodes compared with placebo.…”

Section: Commentsmentioning

confidence: 99%

The Role of Prophylaxis of Bacterial Infections in Children with Acute Leukemia/non-Hodgkin Lymphoma

Castagnola

2014

Pediatric Reports

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Infections represent a well-known complication of antineoplastic chemotherapy that may cause delay of treatment, with alteration of the antineoplastic program and dose-intensity, or even the death of a patient that could heal from his/her neoplasia. Bacterial infections are a major cause of morbidity and mortality in patients who are neutropenic following chemotherapy for malignancy. Therefore a program of antibiotic prophylaxis for febrile neutropenia may be considered in the management strategy of cancer patients.

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Ciprofloxacin Reduces Occurrence of Fever in Children With Acute Leukemia who Develop Neutropenia During Chemotherapy

Cited by 45 publications

References 20 publications

Antibiotic prophylaxis in neutropenic children with acute leukemia: Do the presently available data really support this practice?

Antibiotic prophylaxis in neutropenic children with acute leukemia: Do the presently available data really support this practice?

Safety Concerns Surrounding Quinolone Use in Children

The Role of Prophylaxis of Bacterial Infections in Children with Acute Leukemia/non-Hodgkin Lymphoma

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