Evidence Updates: Antibiotic prophylaxis for bacterial infections in afebrile neutropenic patients following chemotherapy. Cochrane Database Syst Rev includes professional commentaries

AUTHORS' CONCLUSIONS:

Antibiotic prophylaxis in afebrile neutropenic patients significantly reduced all-cause mortality.

In our review, the most significant reduction in mortality was observed in trials assessing prophylaxis with quinolones. The benefits of antibiotic prophylaxis outweighed the harm such as adverse effects and the development of resistance since all-cause mortality was reduced. As most trials in our review were of patients with haematologic cancer, we strongly recommend antibiotic prophylaxis for these patients, preferably with a quinolone.

Prophylaxis may also be considered for patients with solid tumours or lymphoma.

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