Levofloxacin Prevention of Febrile Neutropenia after Cytarabine Consolidation in Acute Myeloid Leukemia.

OBJECTIVE

This study aimed to assess the efficacy of Levofloxacin in preventing febrile neutropenia (FN) after cytarabine-based consolidation therapy in newly diagnosed acute myeloid leukemia (AML) patients.

METHODS

A prospective study conducted between January and December 2023. Newly diagnosed AML patients received Levofloxacin 750 mg once daily for 10 days, starting five days after the last cytarabine dose. Febrile neutropenia was diagnosed based on established guidelines, and outcomes were compared with a historical control group (January 2020 to December 2022) where Levofloxacin prophylaxis was not given.

RESULTS

A total of 43 patients were included, 55% were male with a median age of 42. Levofloxacin recipients (n=19) experienced significantly lower febrile neutropenia incidence compared to the control group (n=24) (36.8% vs. 100%, P<0.001). Levofloxacin prophylaxis also delayed the onset of febrile neutropenia (HR 0.14, 95% CI 0.06-0.36; P<0.001), reduced hospitalization rates (36.8% vs. 100%, P<0.01), and shortened hospital stays (4 vs. 7 days, P=0.002). There were no increases in antibiotic resistance or serious adverse events.

CONCLUSION

Levofloxacin effectively reduced febrile neutropenia episodes, lowered hospitalization rates, and shortened hospital stays in post-cytarabine consolidation AML patients.