Q24. Could you provide a brief summary for physicians who wish to use levofloxacin or other fluoroquinolones as prophylaxis?
Summary: Fluoroquinolones have been shown to have a place in the treatment of patients with febrile neutropenia. Specifically, there is good evidence supporting the use of levofloxacin as prophylactic therapy to reduce the development of febrile neutropenia. The appropriate dose of levofloxacin when administered as preventive therapy is 500 mg once daily (N Engl J Med 2005; 353: 977–87). Levofloxacin can also be used to treat febrile neutropenia in patients classified as having a low risk of serious disease. These patients should be treated with 750 mg once daily. Fluoroquinolones should not be used in high-risk patients for whom parenteral therapy with a broad-spectrum agent is required or in those with a history of fluoroquinolone allergy.