Bacterial sepsis is a major cause of morbidity in children receiving intensive treatment for hematological malignancies and undergoing hematopoietic stem cell transplantation (HSCT). Although studies involving the use of prophylactic antibiotics in neutropenic adult oncology patients have regularly shown their efficacy in reducing the incidence of fever and bacterial infections, the use of prophylactic antibiotics in children with cancer is much more limited. 
This study was carried out to examine the effect of levofloxacin prophylaxis against bacterial infection during profound neutropenia in children undergoing autologous HSCT and also on the length of hospitalization. This observational study carried out at the Bone Marrow Transplantation units of the Childrens’ Cancer Hospital and the El-Sheikh Zayed Specialized Hospital, Egypt, from October 2010 to December 2012. A total of 96 patients were included, 50 of whom received prophylactic levofloxacin (study group) and 46 who did not (control group). A total of 96% of study group patients were fever-free during the first week and 62% remained fever-free during the second week while, in the control group, 67.4% were fever-free during the first week but only 13% remained fever-free during the second week. The relative risk of a febrile episode in patients not receiving levofloxacin was 2.1. Also, the median duration of hospitalization was 24 days in the levofloxacin group compared with 28 days in the control group.
This is the first study in pediatric neutropenic patients demonstrating the benefits of levofloxacin prophylaxis in delaying the onset of fever and reducing the length of hospitalization.

PMID: 26363413

Clin Transplant. 2015 Sep 12. doi: 10.1111/ctr.12635. [Epub ahead of print]

Source : http://www.ncbi.nlm.nih.gov/pubmed/26363413?dopt=Abstract