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Fluoroquinolone prophylaxis in haematopoietic bone marrow transplantation: a driver for antimicrobial resistance

  • N. Mahida
    Correspondence
    Corresponding author. Address: Department of Clinical Microbiology, Nottingham University Hospitals NHS Trust, QMC Campus, Derby Road, Nottingham NG7 2UH, UK. Tel.: +44 (0)115 9249924x61161; fax: +44 (0)115 970 9767.
    Affiliations
    Nottingham University Hospitals NHS Trust, Nottingham, UK
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  • T. Boswell
    Affiliations
    Nottingham University Hospitals NHS Trust, Nottingham, UK
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Published:November 21, 2017DOI:https://doi.org/10.1016/j.jhin.2017.11.009
      Prophylaxis with fluoroquinolones was first recommended by the European Conference on Infections in Leukemia (ECIL) group for high-risk neutropenic patients with an expected length of neutropenia longer than seven days [
      • Bucaneve G.
      • Castagnola E.
      • Viscoli C.
      • Leibovici L.
      • Menichetti F.
      Quinolone prophylaxis for bacterial infections in afebrile high risk neutropenic patients.
      ]. However, even at that time an association between increasing resistance (extended-spectrum β-lactamase (ESBL) producers) and fluoroquinolone prophylaxis had been reported [
      • Paterson D.L.
      • Mulazimoglu L.
      • Casellas J.M.
      • Ko W.C.
      • Goossens H.
      • Von Gottberg A.
      • et al.
      Epidemiology of ciprofloxacin resistance and its relationship to extended-spectrum beta-lactamase production in Klebsiella pneumoniae isolates causing bacteremia.
      ]. More recently, National Institute for Health and Care Excellence (NICE) guidelines have recommended that adult patients with acute leukaemias, stem cell transplants, or solid tumours in whom significant neutropenia is anticipated due to a consequence of chemotherapy should be offered fluoroquinolone prophylaxis [
      • National Institute for Health and Care Excellence
      Neutropenic sepsis: prevention and management in people with cancer.
      ].
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