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首页> 外文期刊>Journal of oncology pharmacy practice: official publication of the International Society of Oncology Pharmacy Practitioners >Impact of fluoroquinolone prophylaxis on infectious-related outcomes after hematopoietic cell transplantation
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Impact of fluoroquinolone prophylaxis on infectious-related outcomes after hematopoietic cell transplantation

机译：氟代喹啉预防对造血细胞移植后感染性相关结果的影响

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Background Patients immediately post-hematopoietic cell transplantation are at high risk for bacteremia. Judicious prophylactic antimicrobial utilization must balance anticipated benefits (reduction infections) versus risk (bacterial resistance, Clostridium difficile). Objective To compare infectious outcomes (primary: incidence bacteremia; secondary: febrile neutropenia, C. difficile, susceptibility of bacteremia, time to discharge and 30-day mortality) between hematopoietic cell transplantation who received fluoroquinolone prophylaxis to those who did not. Methods A local institutional review board-approved retrospective study was conducted on all hematopoietic cell transplantation patients (n = 171) comparing those who received fluoroquinolone prophylaxis (n = 105) to those who did not (n = 66). Data included infectious outcomes and mortality for the first 30 days post-hematopoietic cell transplantation. Chi-squared was performed for categorical variables (GraphPad Software Inc., 2015). Secondary analysis compared outcomes within autologous and allogeneic sub-groups. Results Bacteremia was significantly lower for the overall cohort receiving fluoroquinolone (median duration eight days) versus those without fluoroquinolone (15.2% vs. 31.8%; P 0.01). No difference was seen in C. difficile infection (P = 0.81) or 30-day mortality (2.9% vs. 4.5%; P = 0.67). In the autologous sub-group (n = 115), bacteremia was significantly lower in the fluoroquinolone cohort (8.5% vs. 27.3%; P = 0.0069), while no differences were seen in C. difficile infection (P = 1) or 30-day mortality (P = 1). In the allogeneic sub-group (n = 56), there was no difference between those with and without fluoroquinolone in bacteremia (29.4% vs. 40.9%; P = 0.4) or C. difficile (P = 0.72); however, there was a trend toward improved 30-day mortality (2.9% vs. 9.1%; P = 0.55). Conclusions Fluoroquinolone prophylaxis reduces incidence of bacteremia in autologous hematopoietic cell transplantation without increasing C. difficile after hematopoietic cell transplantation.
机译：背景患者立即造血后细胞移植患者对菌血症的风险很高。明智的预防性抗菌利用率必须平衡预期的益处（减少感染）与风险（细菌抗性，腹菌梭菌）。目的比较传染性结果（初级：发病菌;中学：发热中性粒细胞率，C.艰难症，菌血症敏感性，时间排出和30天死亡率），其接受氟代喹啉预防对那些没有的氟代喹啉预防。方法采用本地制度审查委员会批准的回顾性研究，对所有造血细胞移植患者进行了对比较，将氟喹诺酮预防（n = 105）的那些对没有（n = 66）的人进行比较。数据包括造血后30天的传染性结果和死亡率。对Chi-Squared进行了分类变量（GraphPad Software Inc.，2015）。二次分析在自体和同种异体子组中比较结果。结果菌血症对于接受氟喹诺酮（中位持续时间八天）与没有氟喹诺酮（15.2％vs.31.8％; P <0.01）的总群体的菌血症显着降低。在C.艰难梭菌感染（P = 0.81）或30天死亡率（2.9％vs.4.5％; P = 0.67）中没有差异。在自体亚组（n = 115）中，氟代喹啉队队列中的菌血症显着降低（8.5％vs.27.3％; p = 0.0069），而C.在C.艰难梭菌感染中没有观察到差异（p = 1）或30日死亡率（p = 1）。在同种异体亚组（n = 56）中，在菌血症中没有氟喹诺酮之间的差异（29.4％vs.40.9％; p = 0.4）或C.锥形梭菌（p = 0.72）;然而，提高了30天死亡率的趋势（2.9％对9.1％; P = 0.55）。结论氟代喹啉酮预防性降低了造血细胞移植后的无酸困难的自体造血细胞移植中菌血症的发生率。

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