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Effect of levofloxacin prophylaxis for prevention of severe infections in multiple myeloma patients receiving bortezomib-containing regimens

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Abstract

Fluoroquinolone is recommended as a prophylactic antibiotic for high-risk patients with profound neutropenia. We previously reported that multiple myeloma (MM) patients who received bortezomib-based regimens were at higher risk of severe infections (30.9 %) associated with lymphocytopenia. In the study, we evaluated whether severe infectious complications can be prevented by prophylactic administration of oral levofloxacin in MM patients treated with bortezomib-based regimens. A total of 80 patients received oral levofloxacin 500 mg daily during the median four cycles of treatment. The prophylactic group (n = 80) with levofloxacin showed significantly decreased severe infections compared to a historical control group (n = 139) without levofloxacin prophylaxis during treatment of bortezomib-based regimens (17.5 vs. 30.9 %, P = 0.037). In the prophylactic group, two patients (2.5 %) died of pneumonia and septic shock. Four patients (5 %) stopped levofloxacin due to side effects that consisted of gastrointestinal discomfort (2.5 %), itching sense (1.25 %), and QTc prolongation (1.25 %). In conclusion, prophylaxis with levofloxacin may be effective in the prevention of severe infection in MM patients receiving bortezomib-based regimens. A prospective randomized study is needed to test the prophylactic effect of levofloxacin in MM patients treated with bortezomib-based regimens.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Hematology–Oncology, Chonnam National University Hwasun Hospital, 322 Seoyangro, Hwasun, Jeollanamdo, 519-763, Republic of Korea

    Sung-Hoon Jung, Jae-Sook Ahn, Deok-Hwan Yang, Seung-Shin Lee, Yeo-Kyeoung Kim, Hyeoung-Joon Kim & Je-Jung Lee

  2. Department of Infectious Disease, Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, Republic of Korea

    Seung-Ji Kang & Hee-Chang Jang

Authors
  1. Sung-Hoon Jung
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  2. Seung-Ji Kang
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  4. Jae-Sook Ahn
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  5. Deok-Hwan Yang
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  6. Seung-Shin Lee
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  7. Yeo-Kyeoung Kim
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  8. Hyeoung-Joon Kim
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  9. Je-Jung Lee
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Correspondence to Je-Jung Lee.

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Jung, SH., Kang, SJ., Jang, HC. et al. Effect of levofloxacin prophylaxis for prevention of severe infections in multiple myeloma patients receiving bortezomib-containing regimens. Int J Hematol 100, 473–477 (2014). https://doi.org/10.1007/s12185-014-1672-1

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  • DOI: https://doi.org/10.1007/s12185-014-1672-1

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