Kavallieros, K;
Baltas, I;
Konstantinou, G;
Koutoumanou, E;
Gibani, MM;
Gilchrist, M;
Davies, F;
(2024)
Ciprofloxacin prophylaxis during haematopoietic cell transplantation: a role for use in patients with germ cell tumours?
Journal of medical microbiology
, 73
(6)
, Article 001847. 10.1099/jmm.0.001847.
Preview |
Text
Koutoumanou_Ciprofloxacin prophylaxis during haematopoietic cell transplantation_VoR.pdf Download (2MB) | Preview |
Abstract
INTRODUCTION: Fluoroquinolone prophylaxis during haematopoietic cell transplantation (HCT) can lead to antimicrobial resistance (AMR). Identifying the groups of patients that have the highest likelihood of benefiting from prophylactic antimicrobials is important for antimicrobial stewardship (AMS). HYPOTHESIS: We aimed to identify groups of HCT recipients that have the highest likelihood of benefiting from prophylactic fluroquinolones. METHODS: All admissions for HCT in a tertiary centre between January 2020 and December 2022 (N = 400) were retrospectively studied. Allogeneic HCT (allo-HCT) recipients had prophylaxis with ciprofloxacin during the chemotherapy-induced neutropenia, while autologous HCT (auto-HCT) recipients did not. Bacteraemias were recorded when non-contaminant bacterial pathogens were isolated in blood cultures. RESULTS: Allo-HCT was performed for 43.3 % (173/400) of patients and auto-HCT was performed for 56.7 % (227/400). A bacteraemia was documented in 28.3 % (113/400) of cases. Allo-HCT recipients were more likely to have a Gram-positive bacteraemia (20.8%, 36/173, vs 10.1%, 23/227, P = 0.03), while a difference was not observed for Gram-negative bacteraemias (18.5%, 32/173 vs 18.1%, 41/227, P = 0.91). Among auto-HCT recipients not receiving ciprofloxacin prophylaxis, patients with germ cell tumours had the highest probability (P for trend 0.09) of recording any bacteraemia (43.5%, 10/23) followed by patients with lymphomas (32.5%, 13/40), other auto-HCT indications (22.2%, 2/9), multiple myeloma (22.1%, 29/131) and multiple sclerosis (12.5%, 3/24). The higher number of bacteraemias in patients with germ cell tumours was primarily driven by Gram-negative pathogens. CONCLUSIONS: Ciprofloxacin prophylaxis was associated with a reduced incidence of Gram-negative bacteraemias in allo-HCT recipients. Auto-HCT recipients due to germ cell tumours, not receiving ciprofloxacin prophylaxis, recorded the highest incidence of bacteraemias and represent a possible target group for this intervention.
| Type: | Article |
|---|---|
| Title: | Ciprofloxacin prophylaxis during haematopoietic cell transplantation: a role for use in patients with germ cell tumours? |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1099/jmm.0.001847 |
| Publisher version: | http://dx.doi.org/10.1099/jmm.0.001847 |
| Language: | English |
| Additional information: | © 2024 The Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). |
| Keywords: | allografts, antimicrobial drug resistance, autografts, ciprofloxacin, hematopoietic stem cell transplantation, neoplasms, germ cell and embryonal |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10194992 |
Archive Staff Only
 |
View Item |
