Levofloxacin for the prevention of febrile episodes in non-Hodgkin lymphoma patients treated with CHOP plus rituximab in a randomized controlled trial.

Journal: Scientific reports

This randomized, single-blind, placebo-controlled trial evaluated the effectiveness of levofloxacin prophylaxis in 80 non-Hodgkin lymphoma patients receiving R-CHOP chemotherapy with G-CSF support.

Levofloxacin (500 mg daily for 7 days post-chemotherapy) significantly reduced:

  • Febrile episodes: 7.5% vs. 30%
  • Febrile neutropenia: 2.5% vs. 20%
  • Composite outcome: septic shock, mortality, and chemotherapy dose reduction

Fever-free survival improved, with a hazard ratio of 0.23. Multivariate analysis confirmed a lower risk of febrile episodes in the levofloxacin group.

No increase in mortality or serious adverse events was observed.

The study supports levofloxacin as an effective and well-tolerated prophylactic strategy in this setting, with a recommendation for ongoing antibiotic resistance monitoring.

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