Eric J. Bow, MD
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Bow E.; Gram-Positive Infections and Quinolones in Neutropenia. Ann Intern Med. 1997;126:831. doi: 10.7326/0003-4819-126-10-199705150-00028
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Published: Ann Intern Med. 1997;126(10):831.
Altclas and colleagues and Drs. Castagnola and Viscoli have cited many of the disadvantages of selective quinolone prophylaxis, including colonization and subsequent infection by opportunistic yeasts; reduction in prophylactic efficacy associated with the increasing prevalence of quinolone-resistant microorganisms in many centers; and lack of consistent effect on such outcomes as febrile morbidity, infection-related mortality, and the pattern of prescribing parenteral antimicrobial agents. Despite these criticisms, a reduction in the incidence of infection with aerobic gram-negative bacilli has been the outcome most consistently shown in clinical trials. However, differences in mortality rates related to gram-negative infection have been harder to demonstrate because of the confounding bias of the highly effective parenteral regimens of antibacterial agents for gram-negative organisms now available. Limited experience suggests that successful prophylaxis can reduce the need for parenteral antibacterial therapy [1, 2]; however, larger, carefully designed, randomized, controlled clinical trials are required for validation.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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