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Prophylaxis with levofloxacin: impact on bacterial susceptibility and epidemiology in a hematopoietic stem cell transplant unit
Lopes, Livia Amaral Alonso; Veroneze, Izelândia; Burgardt, Célia Inês; Stier, Christiane Johnscher Niebel.
Afiliação
  • Lopes, Livia Amaral Alonso; Universidade Federal do Paraná. Curitiba. BR
  • Veroneze, Izelândia; Universidade Federal do Paraná. Curitiba. BR
  • Burgardt, Célia Inês; Universidade Federal do Paraná. Curitiba. BR
  • Stier, Christiane Johnscher Niebel; Universidade Federal do Paraná. Curitiba. BR
Rev. bras. hematol. hemoter ; Rev. bras. hematol. hemoter;36(1): 35-42, Jan-Feb/2014. tab, graf
Article em En | LILACS | ID: lil-703699
Biblioteca responsável: BR408.1
ABSTRACT

Background:

The emergence of resistance has been demonstrated in cancer treatment centers where prophylaxis with fluoroquinolone is used.

Objective:

Considering the importance of epidemiological monitoring as a strategy in choosing protocols involving antibiotics, this study aimed to evaluate the emergence of quinolone resistance and changes in the local epidemiology in a hematopoietic stem cell transplant service.

Methods:

For this study, 60 positive cultures before the prophylactic use of levofloxacin (period A 2007-2008) and 118 cultures after starting the use of prophylactic levofloxacin (period B 2010-2011) were evaluated.

Results:

Resistance increased for all the different types of bacteria isolated (from 46.0% to 76.5%; p-value = 0.0002). Among Gram-negative bacteria, resistance increased from 21.4% to 60.7% (p-value = 0.0163) and among Gram-positive bacteria, it increased from 55.6% to 82.9% (p-value = 0.0025). The use of levofloxacin increased from 19.44 defined daily doses per 1,000 patient-days in period A to 166.64 in period B. The use of broad spectrum antibiotics remained unchanged. Considering bacteria associated with infection, 72 and 76 were isolated in periods A and B, respectively. There was a reduction in the rate of Gramnegative bacteria in cultures associated with infection (3.81 vs. 2.00 cultures/1,000 patientdays; p-value = 0.008).

Conclusion:

The study of prophylaxis with levofloxacin demonstrated that there was a decrease in infections by Gram-negative bacteria; however, bacterial resistance increased, even though the use of broad-spectrum antibiotics remained unchanged. Constant monitoring of local epidemiology combined with research on clinical outcomes is needed to evaluate the effectiveness of prophylaxis. .
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Texto completo: 1 Base de dados: LILACS Assunto principal: Resistência a Medicamentos / Ofloxacino / Epidemiologia / Transplante de Células-Tronco Hematopoéticas / Antibioticoprofilaxia / Fluoroquinolonas / Suscetibilidade a Doenças Idioma: En Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Base de dados: LILACS Assunto principal: Resistência a Medicamentos / Ofloxacino / Epidemiologia / Transplante de Células-Tronco Hematopoéticas / Antibioticoprofilaxia / Fluoroquinolonas / Suscetibilidade a Doenças Idioma: En Ano de publicação: 2014 Tipo de documento: Article