2019
DOI: 10.1002/cam4.2395
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Efficacy of antibiotic prophylaxis in patients with cancer and hematopoietic stem cell transplantation recipients: A systematic review of randomized trials

Abstract: Purpose To determine the efficacy and safety of different prophylactic systemic antibiotics in adult and pediatric patients receiving chemotherapy or undergoing hematopoietic stem cell transplantation (HSCT). Methods We conducted a systematic review and performed searches of Ovid MEDLINE, MEDLINE in‐process and Embase; and Cochrane Central Register of Controlled Trials. Studies were included if patients had cancer or were HSCT recipients with anticipated neutropenia, an… Show more

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Cited by 59 publications
(68 citation statements)
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“…Second, based on a recent estimate, 16 the direct health care costs due to antimicrobial resistance associated with increased broad‐spectrum antibiotic use are negligible: $0.00‐$0.01 per standard unit of antibiotics; though indirect costs, not included in our model, are estimated to be higher. Third, the long‐term impacts of routine fluoroquinolone prophylaxis on antimicrobial resistance and health outcomes are unclear 15,27,28 . Fourth, it is unclear how rates and patterns of antimicrobial resistance compare between levofloxacin prophylaxis and no prophylaxis groups, given the potential effects of prophylaxis on rates of exposure to other broad‐spectrum antibiotics and the effects of chemotherapy itself on resistance patterns 10,29 …”
Section: Methodsmentioning
confidence: 99%
See 1 more Smart Citation
“…Second, based on a recent estimate, 16 the direct health care costs due to antimicrobial resistance associated with increased broad‐spectrum antibiotic use are negligible: $0.00‐$0.01 per standard unit of antibiotics; though indirect costs, not included in our model, are estimated to be higher. Third, the long‐term impacts of routine fluoroquinolone prophylaxis on antimicrobial resistance and health outcomes are unclear 15,27,28 . Fourth, it is unclear how rates and patterns of antimicrobial resistance compare between levofloxacin prophylaxis and no prophylaxis groups, given the potential effects of prophylaxis on rates of exposure to other broad‐spectrum antibiotics and the effects of chemotherapy itself on resistance patterns 10,29 …”
Section: Methodsmentioning
confidence: 99%
“…Recent evidence suggests similar benefits in children with acute leukemia receiving intensive chemotherapy, where levofloxacin prophylaxis has been shown to reduce the risk of fever and neutropenia, bacteremia, and the need for other broad‐spectrum antibiotics 10,11 . However, exposure to levofloxacin is associated with risks of adverse effects, including Clostridium difficile ‐associated colitis, susceptibility to invasive fungal disease, infection or colonization with fluoroquinolone‐resistant pathogens, and musculoskeletal and neurological toxicities 9‐15 . Additionally, prophylactic antibiotics are associated with current‐period costs, including drug costs and health care costs due to drug toxicities 9,16 .…”
Section: Introductionmentioning
confidence: 99%
“…[11] We recently conducted a systematic review of randomized trials of systemic antibacterial prophylaxis and described the efficacy and adverse effects associated with different systemic antibiotics. [12] We included both adult and pediatric trials in data synthesis. For this CPG, we updated the systematic review and separately summarized the pediatric data.…”
Section: Searching Selecting and Describing The Evidencementioning
confidence: 99%
“…Prophylactic antibiotics can be used to reduce infections in neutropenic patients. ASCO/ IDSA guidelines recommend that antibacterial and antifungal prophylaxis be restricted to patients at high risk of infection, including patients who are expected to have profound, protracted neutropenia, which is defined as < 100 neutrophils/μL for > 7 days or other risk factors [33,45]. In patients with solid tumors, antibacterial and antifungal prophylaxis would generally not be indicated when G-CSF prophylaxis effectively reduces the magnitude and duration of neutropenia.…”
Section: Expanded Use Of Granulocyte Colony-stimulating Factor Duringmentioning
confidence: 99%