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Review: Levofloxacin Prophylaxis in Pediatric Oncology Patients

  • Pediatric Infectious Disease (M Mitchell and F Zhu, Section Editors)
  • Published:
Current Treatment Options in Pediatrics Aims and scope Submit manuscript

Abstract

Purpose of review

Bacterial sepsis is a leading cause of morbidity and mortality among pediatric cancer patients receiving intensive chemotherapy. While there are treatment guidelines for empiric antimicrobial therapy for fever with neutropenia, the role of prophylactic antibacterial agents has been widely debated and is less well-defined.

Recent findings

Demonstrable benefits of fluoroquinolone prophylaxis (specifically levofloxacin) include prevention of bacteremia and potentially fevers during neutropenia, though with limited if any impact on mortality. However, the risks of using antibacterial prophylaxis include antimicrobial over-utilization, antimicrobial resistance, Clostridioides difficile colitis, and stool dysbiosis with associated risk of graft versus host disease and mortality.

Summary

This review article outlines the current literature and provides guidance for decisions about levofloxacin prophylaxis in the pediatric oncology population.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Hematology/Oncology/Blood and Marrow Transplantation, Medical College of Wisconsin and Children’s Wisconsin, Milwaukee, WI, USA

    Amanda Scheuermann DO

  2. Department of Pediatrics, Division of Infectious Diseases, Medical College of Wisconsin and Children’s Wisconsin, Milwaukee, WI, USA

    Anna R. Huppler MD & Michelle Mitchell MD

  3. Department of Medicine, Division of Infectious Diseases, Froedtert and the Medical College of Wisconsin, Milwaukee, WI, USA

    Jaime S. Green MD

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Correspondence to Amanda Scheuermann DO.

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Scheuermann, A., Huppler, A.R., Mitchell, M. et al. Review: Levofloxacin Prophylaxis in Pediatric Oncology Patients. Curr Treat Options Peds 8, 211–231 (2022). https://doi.org/10.1007/s40746-022-00251-0

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