Efficacy of antibiotic prophylaxis in patients with cancer and hematopoietic stem cell transplantation recipients: A systematic review of randomized trials

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Efficacy of antibiotic prophylaxis in patients with cancer and hematopoietic stem cell transplantation recipients : A systematic review of randomized trials. / Egan, Grace; Robinson, Paula D; Martinez, Juan P D; Alexander, Sarah; Ammann, Roland A; Dupuis, L Lee; Fisher, Brian T; Lehrnbecher, Thomas; Phillips, Bob; Cabral, Sandra; Tomlinson, George; Sung, Lillian.

In: Cancer Medicine, 05.07.2019.

Research output: Contribution to journalReview articlepeer-review

Harvard

Egan, G, Robinson, PD, Martinez, JPD, Alexander, S, Ammann, RA, Dupuis, LL, Fisher, BT, Lehrnbecher, T, Phillips, B, Cabral, S, Tomlinson, G & Sung, L 2019, 'Efficacy of antibiotic prophylaxis in patients with cancer and hematopoietic stem cell transplantation recipients: A systematic review of randomized trials', Cancer Medicine. https://doi.org/10.1002/cam4.2395

APA

Egan, G., Robinson, P. D., Martinez, J. P. D., Alexander, S., Ammann, R. A., Dupuis, L. L., Fisher, B. T., Lehrnbecher, T., Phillips, B., Cabral, S., Tomlinson, G., & Sung, L. (2019). Efficacy of antibiotic prophylaxis in patients with cancer and hematopoietic stem cell transplantation recipients: A systematic review of randomized trials. Cancer Medicine. https://doi.org/10.1002/cam4.2395

Vancouver

Egan G, Robinson PD, Martinez JPD, Alexander S, Ammann RA, Dupuis LL et al. Efficacy of antibiotic prophylaxis in patients with cancer and hematopoietic stem cell transplantation recipients: A systematic review of randomized trials. Cancer Medicine. 2019 Jul 5. https://doi.org/10.1002/cam4.2395

Author

Egan, Grace ; Robinson, Paula D ; Martinez, Juan P D ; Alexander, Sarah ; Ammann, Roland A ; Dupuis, L Lee ; Fisher, Brian T ; Lehrnbecher, Thomas ; Phillips, Bob ; Cabral, Sandra ; Tomlinson, George ; Sung, Lillian. / Efficacy of antibiotic prophylaxis in patients with cancer and hematopoietic stem cell transplantation recipients : A systematic review of randomized trials. In: Cancer Medicine. 2019.

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@article{2d0da9f16bed4e0888e3397b37117a0e,
title = "Efficacy of antibiotic prophylaxis in patients with cancer and hematopoietic stem cell transplantation recipients: A systematic review of randomized trials",
abstract = "PURPOSE: To determine the efficacy and safety of different prophylactic systemic antibiotics in adult and pediatric patients receiving chemotherapy or undergoing hematopoietic stem cell transplantation (HSCT).METHODS: We conducted a systematic review and performed searches of Ovid MEDLINE, MEDLINE in-process and Embase; and Cochrane Central Register of Controlled Trials. Studies were included if patients had cancer or were HSCT recipients with anticipated neutropenia, and the intervention was systemic antibacterial prophylaxis. Strategies synthesized included fluoroquinolone vs no antibiotic/nonabsorbable antibiotic; fluoroquinolone vs trimethoprim-sulfamethoxazole; trimethoprim-sulfamethoxazole vs no antibiotic; and cephalosporin vs. no antibiotic. Fluoroquinolone vs cephalosporin and levofloxacin vs ciprofloxacin were compared by network meta-analysis. Primary outcome was bacteremia.RESULTS: Of 20 984 citations screened, 113 studies comparing prophylactic antibiotic to control were included. The following were effective in reducing bacteremia: fluoroquinolone vs no antibiotic/nonabsorbable antibiotic (risk ratio (RR) 0.56, 95% confidence interval (CI) 0.41-0.76), trimethoprim-sulfamethoxazole vs no antibiotic (RR 0.59, 95% CI 0.41-0.85) and cephalosporin vs no antibiotic (RR 0.30, 95% CI 0.16-0.58). Fluoroquinolone was not significantly associated with increased Clostridium difficile infection (RR 0.62, 95% CI 0.31-1.24) or invasive fungal disease (RR 1.28, 95% CI 0.79-2.08) but did increase resistance to fluoroquinolone among bacteremia isolates (RR 3.35, 95% CI 1.12 to 10.03). Heterogeneity in fluoroquinolone effect on bacteremia was not explained by evaluated study, population, or methodological factors. Network meta-analysis revealed no direct comparisons for pre-specified analyses; superior regimens were not identified.CONCLUSIONS: Fluoroquinolone, trimethoprim-sulfamethoxazole, and cephalosporin prophylaxis reduced bacteremia. A clinical practice guideline to facilitate prophylactic antibiotic decision-making is required.",
author = "Grace Egan and Robinson, {Paula D} and Martinez, {Juan P D} and Sarah Alexander and Ammann, {Roland A} and Dupuis, {L Lee} and Fisher, {Brian T} and Thomas Lehrnbecher and Bob Phillips and Sandra Cabral and George Tomlinson and Lillian Sung",
note = "{\textcopyright} 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.",
year = "2019",
month = jul,
day = "5",
doi = "10.1002/cam4.2395",
language = "English",
journal = "Cancer Medicine",
issn = "2045-7634",
publisher = "John Wiley and Sons Ltd",

}

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TY - JOUR

T1 - Efficacy of antibiotic prophylaxis in patients with cancer and hematopoietic stem cell transplantation recipients

T2 - A systematic review of randomized trials

AU - Egan, Grace

AU - Robinson, Paula D

AU - Martinez, Juan P D

AU - Alexander, Sarah

AU - Ammann, Roland A

AU - Dupuis, L Lee

AU - Fisher, Brian T

AU - Lehrnbecher, Thomas

AU - Phillips, Bob

AU - Cabral, Sandra

AU - Tomlinson, George

AU - Sung, Lillian

N1 - © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

PY - 2019/7/5

Y1 - 2019/7/5

N2 - PURPOSE: To determine the efficacy and safety of different prophylactic systemic antibiotics in adult and pediatric patients receiving chemotherapy or undergoing hematopoietic stem cell transplantation (HSCT).METHODS: We conducted a systematic review and performed searches of Ovid MEDLINE, MEDLINE in-process and Embase; and Cochrane Central Register of Controlled Trials. Studies were included if patients had cancer or were HSCT recipients with anticipated neutropenia, and the intervention was systemic antibacterial prophylaxis. Strategies synthesized included fluoroquinolone vs no antibiotic/nonabsorbable antibiotic; fluoroquinolone vs trimethoprim-sulfamethoxazole; trimethoprim-sulfamethoxazole vs no antibiotic; and cephalosporin vs. no antibiotic. Fluoroquinolone vs cephalosporin and levofloxacin vs ciprofloxacin were compared by network meta-analysis. Primary outcome was bacteremia.RESULTS: Of 20 984 citations screened, 113 studies comparing prophylactic antibiotic to control were included. The following were effective in reducing bacteremia: fluoroquinolone vs no antibiotic/nonabsorbable antibiotic (risk ratio (RR) 0.56, 95% confidence interval (CI) 0.41-0.76), trimethoprim-sulfamethoxazole vs no antibiotic (RR 0.59, 95% CI 0.41-0.85) and cephalosporin vs no antibiotic (RR 0.30, 95% CI 0.16-0.58). Fluoroquinolone was not significantly associated with increased Clostridium difficile infection (RR 0.62, 95% CI 0.31-1.24) or invasive fungal disease (RR 1.28, 95% CI 0.79-2.08) but did increase resistance to fluoroquinolone among bacteremia isolates (RR 3.35, 95% CI 1.12 to 10.03). Heterogeneity in fluoroquinolone effect on bacteremia was not explained by evaluated study, population, or methodological factors. Network meta-analysis revealed no direct comparisons for pre-specified analyses; superior regimens were not identified.CONCLUSIONS: Fluoroquinolone, trimethoprim-sulfamethoxazole, and cephalosporin prophylaxis reduced bacteremia. A clinical practice guideline to facilitate prophylactic antibiotic decision-making is required.

AB - PURPOSE: To determine the efficacy and safety of different prophylactic systemic antibiotics in adult and pediatric patients receiving chemotherapy or undergoing hematopoietic stem cell transplantation (HSCT).METHODS: We conducted a systematic review and performed searches of Ovid MEDLINE, MEDLINE in-process and Embase; and Cochrane Central Register of Controlled Trials. Studies were included if patients had cancer or were HSCT recipients with anticipated neutropenia, and the intervention was systemic antibacterial prophylaxis. Strategies synthesized included fluoroquinolone vs no antibiotic/nonabsorbable antibiotic; fluoroquinolone vs trimethoprim-sulfamethoxazole; trimethoprim-sulfamethoxazole vs no antibiotic; and cephalosporin vs. no antibiotic. Fluoroquinolone vs cephalosporin and levofloxacin vs ciprofloxacin were compared by network meta-analysis. Primary outcome was bacteremia.RESULTS: Of 20 984 citations screened, 113 studies comparing prophylactic antibiotic to control were included. The following were effective in reducing bacteremia: fluoroquinolone vs no antibiotic/nonabsorbable antibiotic (risk ratio (RR) 0.56, 95% confidence interval (CI) 0.41-0.76), trimethoprim-sulfamethoxazole vs no antibiotic (RR 0.59, 95% CI 0.41-0.85) and cephalosporin vs no antibiotic (RR 0.30, 95% CI 0.16-0.58). Fluoroquinolone was not significantly associated with increased Clostridium difficile infection (RR 0.62, 95% CI 0.31-1.24) or invasive fungal disease (RR 1.28, 95% CI 0.79-2.08) but did increase resistance to fluoroquinolone among bacteremia isolates (RR 3.35, 95% CI 1.12 to 10.03). Heterogeneity in fluoroquinolone effect on bacteremia was not explained by evaluated study, population, or methodological factors. Network meta-analysis revealed no direct comparisons for pre-specified analyses; superior regimens were not identified.CONCLUSIONS: Fluoroquinolone, trimethoprim-sulfamethoxazole, and cephalosporin prophylaxis reduced bacteremia. A clinical practice guideline to facilitate prophylactic antibiotic decision-making is required.

U2 - 10.1002/cam4.2395

DO - 10.1002/cam4.2395

M3 - Review article

C2 - 31274245

JO - Cancer Medicine

JF - Cancer Medicine

SN - 2045-7634

ER -