In a nutshell
The study evaluated the safety and effectiveness of levofloxacin (Levaquin) treatment for the prevention of infections among patients with newly diagnosed myeloma. The main finding was that levofloxacin treatment reduced fever and death during the first 12 weeks of myeloma therapy.
Myeloma is a cancer that affects the immune system. The risk of infection is very high during the first 12 weeks of myeloma therapy. This can lead to a higher mortality risk.
Quinolones are a group of antibiotics that include levofloxacin. Treatment with quinolones reduces infection and death in patients with a low white blood cell count. However, some bacteria become resistant to antibiotics. These resistant bacteria can cause healthcare-associated infection (HAIs) during medical procedures. It is unknown if patients newly diagnosed with myeloma benefit from levofloxacin prophylaxis (treatment given to prevent an illness) and the effect of this treatment on HAIs.
Methods & findings
977 patients with newly diagnosed myeloma were included in this study. All patients were within 14 days of starting myeloma therapy. 489 patients received 500 mg of levofloxacin daily for 12 weeks. Placebo treatment was given to the other 488 patients. All patients were followed-up for an average of 12 months.
First episodes of fever or death occurred in 19% of patients receiving levofloxacin and in 27% receiving placebo. There was a 34% lower risk of fever or death in the levofloxacin group compared to placebo. Serious side effects were similarly reported in the two groups.
The bottom line
The authors concluded that adding levofloxacin to the first 12 weeks of myeloma therapy decreased fevers and deaths in patients with newly diagnosed myeloma, without increasing the risk of HAIs.
The fine print
This study was performed on the patients in UK only. Similar studies are needed in other countries with high levels of antibiotic-resistance.
Published By :
The Lancet. Oncology
Oct 23, 2019
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