Document Type : Research Articles
Authors
1
Division of Hematology, Department of Medicine, Hatyai Hospital, Songkhla, Thailand.
2
Department of Hematology, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.
3
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
4
Division of Hematology, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
5
Center of Excellence in Translational Hematology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Abstract
Objective: This study aimed to assess the efficacy of Levofloxacin in preventing febrile neutropenia (FN) after cytarabine-based consolidation therapy in newly diagnosed acute myeloid leukemia (AML) patients. Methods: A prospective study conducted between January and December 2023. Newly diagnosed AML patients received Levofloxacin 750 mg once daily for 10 days, starting five days after the last cytarabine dose. Febrile neutropenia was diagnosed based on established guidelines, and outcomes were compared with a historical control group (January 2020 to December 2022) where Levofloxacin prophylaxis was not given. Results: A total of 43 patients were included, 55% were male with a median age of 42. Levofloxacin recipients (n=19) experienced significantly lower febrile neutropenia incidence compared to the control group (n=24) (36.8% vs. 100%, P<0.001). Levofloxacin prophylaxis also delayed the onset of febrile neutropenia (HR 0.14, 95% CI 0.06-0.36; P<0.001), reduced hospitalization rates (36.8% vs. 100%, P<0.01), and shortened hospital stays (4 vs. 7 days, P=0.002). There were no increases in antibiotic resistance or serious adverse events. Conclusion: Levofloxacin effectively reduced febrile neutropenia episodes, lowered hospitalization rates, and shortened hospital stays in post-cytarabine consolidation AML patients.
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