Supportive Care in Cancer

, Volume 25, Issue 12, pp 3715–3721 | Cite as

Moxifloxacin versus levofloxacin or ciprofloxacin prophylaxis in acute myeloid leukemia patients receiving chemotherapy

Original Article
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Abstract

Purpose

Patients receiving intensive chemotherapy regimens are at high risk for infectious complications due to prolonged neutropenia and hospital stay. Fluoroquinolone antibiotics, mainly levofloxacin and ciprofloxacin, are the mainstay of prophylactic therapy for these patients. There is limited data regarding the utilization of other quinolone antibiotics including moxifloxacin in this setting.

Methods

A retrospective chart review was completed comparing the use of prophylactic moxifloxacin to that of levofloxacin or ciprofloxacin during periods of prolonged neutropenia. Adult patients admitted to a community teaching hospital while receiving induction or reinduction chemotherapy for acute myeloid leukemia were included.

Results

One hundred and forty-one patients were included in this study. The two groups displayed slight heterogeneity: patients receiving moxifloxacin were approximately 10 years younger (54 vs. 64 years, p = 0.01), more likely to receive granulocyte colony stimulating factor (GCSF) (45 vs. 19%, p = 0.001), and neutropenic for a longer duration (23 vs. 19 days, p = 0.009). The incidence of febrile neutropenia (76 vs. 81%, RR 0.93, 95% CI 0.78–1.11, p = 0.42) and of documented infections (27 vs. 33%, RR 0.82, 95% CI 0.49–1.36, p = 0.44) was similar between those receiving moxifloxacin and levofloxacin/ciprofloxacin, respectively. Hospital readmission for an infectious issue within 30 days of hospital discharge (9 vs. 5%, p = 0.39) was also similar between groups as was the incidence of Clostridium difficile (9 vs. 9%, p = 0.96).

Conclusions

Moxifloxacin may be an alternative to levofloxacin or ciprofloxacin in patients with a prolonged risk of febrile neutropenia requiring prophylaxis.

Keywords

Fluoroquinolone prophylaxis Febrile neutropenia Acute myeloid leukemia Moxifloxacin 

Abbreviations

AML

Acute myeloid leukemia

GCSF

Granulocyte colony stimulating factor

C. diff

Clostridium difficile

RCT

Randomized controlled trial

ESBL

Extended spectrum beta-lactamase

SP

Standard of prophylaxis

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.College of Pharmacy and Health SciencesButler UniversityIndianapolisUSA
  2. 2.Department of PharmacySt. Vincent Indianapolis HospitalIndianapolisUSA

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