Preventing infection during stem cell transplant with antibiotics

This study examined the use of the antibiotics doxycycline and ciprofloxacin to prevent infections in multiple myeloma. The study concluded that adding doxycycline to ciprofloxacin reduced the number of bacterial infections.

Stem cell transplantation and chemotherapy are commonly used to treat multiple myeloma. These treatments can cause low levels of white blood cells. This increases the risk of infection and death. Antibiotics are often given to prevent infection.

Fluoroquinolones are a group of antibiotics. The standard treatment for preventing infection is a fluoroquinolone such as ciprofloxacin. However, even with antibiotics, about 15-20% of patients get an infection. Previous research has found that adding doxycycline (another antibiotic) to a fluoroquinolone may reduce infections in patients undergoing stem cell transplant.

This study included 419 patients with multiple myeloma who underwent stem cell transplant. 118 patients received ciprofloxacin alone to prevent infection. 301 patients received ciprofloxacin and doxycycline to prevent infection.

53% of patients who received ciprofloxacin alone developed a fever and low white blood cell count. 36% of patients who received additional doxycycline developed a fever and low white blood cell count. 11% of patients who received ciprofloxacin alone had a bacterial infection. 4.7% of patients who received an additional doxycycline had a bacterial infection.

Bacteria that could resist antibiotic treatment was not common. Overall, 3% of patients had a virus infection. 1% of patients had a fungal infection. The most common reason for stopping antibiotics was a rash. 2% of patients who received ciprofloxacin alone had a rash. 2% of patients who received an additional doxycycline had a rash.

The authors concluded that adding doxycycline to ciprofloxacin reduced the number of bacterial infections in patients undergoing stem cell transplant for multiple myeloma.