Is there a benefit to providing antibiotic prophylaxis to patients being treated for multiple myeloma?

FAQ Library published on July 16, 2018
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Philip L. McCarthy, MD
Professor of Oncology
Director, Blood and Marrow Transplant Program
Roswell Park Cancer Institute
Buffalo, New York

Welcome to Managing Myeloma, I am Dr. Philip McCarthy. Today, I would like to discuss whether there is a benefit to providing antibiotic prophylaxis to patients being treated for multiple myeloma. In the past, patients who presented with myeloma often would have what is called immune paresis where their normal immunoglobulins would be suppressed by the abnormal clone. Some of these patients would be at risk for developing infections before they were treated or during therapy. In a randomized phase 3 study, the British group looked at almost one thousand patients and randomized them to either levofloxacin antibiotic prophylaxis or placebo during the first 12 weeks of induction therapy. What they found was that there was a decrease in infectious complications as well as deaths in those patients who received levofloxacin when compared to placebo. Further, when they looked at those patients who received rimethoprim/sulfamethoxazole in addition to antimicrobial prophylaxis, they found an even greater benefit. We think that this may become a new standard. It is not quite part of the guidelines yet but the results are impressive in abstract form. We will wait to see the manuscript to evaluate it and then determine if this will now become a new standard for those patients who are receiving induction therapy. Thank you very much for viewing this activity.

Last modified: July 16, 2018
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