ORIGINAL RESEARCH article
Front. Microbiol.
Sec. Antimicrobials, Resistance and Chemotherapy
Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1632055
This article is part of the Research TopicMultidrug Resistant Gram-negative Bacteria in Fragile HostsView all 10 articles
LOW RATE OF INFECTIOUS MORTALITY OMITTING FLUOROQUINOLONE PROPHYLAXIS IN HIGH-RISK HEMATOLOGICAL PATIENTS, A SINGLE CENTER EXPERIENCE
Provisionally accepted
Adele Santoni1*
Margherita Malchiodi1
Elisabetta Zappone2
Alessandra Cartocci1
Anna Sicuranza1
Paola Pacelli1Corrado Zuanelli Brambilla2
Marzia Defina2
Mario Tumbarello1
Monica Bocchia1- 1University of Siena, Siena, Italy
- 2Siena University Hospital, Siena, Tuscany, Italy
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In intensive chemotherapy treated hematologic patients, febrile neutropenia (FN) is the main cause of nonrelapse mortality due to infections occurring during prolonged neutropenia. Fluoroquinolone (FQ) prophylaxis in neutropenic patients is still recommended in several guidelines because it reduces bacterial infection rate and fever episodes, while not impacting on infectious related mortality (IRM). However, in the multi-drug resistance (MDR) era FQ use should be evaluated carefully.We report a retrospective single center real-life experience of 512 intensive chemotherapy treatments and subsequent prolonged neutropenia in 236 high risk (HR) hematological patients treated omitting FQ prophylaxis.In the whole cohort we registered 80.5% FN: 33.7% fever of unknown origin, 45.4% bloodstream infections, 9.0% bacterial organ infections, 13.6% fungal and 3.4% viral infections. We recorded 7.6% septic shocks.Although we documented a high infections rate, IRM and overall mortality were 3.0% (7/236) and 9.3% (22/236) respectively, like comparable settings including FQ prophylaxis.Despite the small cohort, our results support the decision to omit FQ prophylaxis in HR hematological patients, without increasing IRM and containing MDR life-threatening infections risk. Although we think it is mandatory to have an efficient protocol for a prompt treatment of FN, our data should encourage hematologists to limit FQ prophylaxis.
Keywords: Febrile neutropenia, Fluoroquilone, Bloodstream infection (BSI), Hematological malignances, prophylaxis, acute myeloic leukemia (AML), acute lymphobastic leukemia, Non Hodgkin Lymphoma
Received: 20 May 2025; Accepted: 15 Aug 2025.
Copyright: © 2025 Santoni, Malchiodi, Zappone, Cartocci, Sicuranza, Pacelli, Zuanelli Brambilla, Defina, Tumbarello and Bocchia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Adele Santoni, University of Siena, Siena, Italy
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