Abstract | BACKGROUND: PURPOSE: DATA SOURCES: The Cochrane Cancer Network register of trials (2004), The Cochrane Library (Issue 4, 2004), EMBASE (1980-2004), MEDLINE (1966-2004), and references of identified studies. STUDY SELECTION: DATA EXTRACTION: Two reviewers independently appraised the quality of trials and extracted data. DATA SYNTHESIS: Ninety-five trials performed between 1973 and 2004 met inclusion criteria. Fifty-two trials addressed quinolone prophylaxis. Antibiotic prophylaxis significantly decreased the risk for death when compared with placebo or no treatment (relative risk, 0.67 [95% CI, 0.55 to 0.81]). All prophylactic antibiotics were associated with an increased risk for adverse events (relative risk, 1.69 [CI, 1.14 to 2.50]). Fluoroquinolone prophylaxis reduced the risk for all-cause mortality (relative risk, 0.52 [CI, 0.35 to 0.77]), as well as infection-related mortality, fever, clinically documented infections, and microbiologically documented infections. Fluoroquinolone prophylaxis increased the risk for harboring bacilli resistant to the specific drug after treatment and adverse events, but these results were not statistically significant (relative risks, 1.69 [CI, 0.73 to 3.92]) and 1.30 [CI, 0.61 to 2.76], respectively). LIMITATIONS: Most trials involved patients with hematologic cancer. Data on all-cause mortality were missing in 10 of 50 trials comparing prophylaxis with no prophylaxis. Effect estimates were larger in trials of unclear methodologic quality compared with trials of adequate methodologic quality. CONCLUSIONS:
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Authors | Anat Gafter-Gvili, Abigail Fraser, Mical Paul, Leonard Leibovici |
Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 142
Issue 12 Pt 1
Pg. 979-95
(Jun 21 2005)
ISSN: 1539-3704 [Electronic] United States |
PMID | 15968013
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antineoplastic Agents
- Fluoroquinolones
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Topics |
- Antibiotic Prophylaxis
- Antineoplastic Agents
(adverse effects)
- Bacterial Infections
(prevention & control)
- Biomedical Research
- Fluoroquinolones
(therapeutic use)
- Hematologic Neoplasms
(drug therapy)
- Humans
- Neutropenia
(chemically induced, complications, mortality)
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