{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:22:57Z","timestamp":1786123377805,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Patients with acute myeloid leukemia (AML) undergoing induction chemotherapy are at high\u2010risk of bloodstream infections, including central line\u2010associated bloodstream infections (CLABSI) or mucosal barrier injury\u2010related infections (MBI\u2010LCBI). The impact of fluoroquinolone (FQ) prophylaxis on MBI\u2010LCBI,\n Clostridioides difficile<\/jats:italic>\n , and intensive care unit (ICU) outcomes in this population remains unclear.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We retrospectively reviewed adults with AML receiving induction chemotherapy between 2010 and 2022. Patients were grouped by receipt of FQ prophylaxis. Primary outcomes were incidence of CLABSI, and MBI\u2010LCBI. Secondary outcomes included neutropenic fever, ICU admission, length of stay, and\n C. difficile<\/jats:italic>\n infection. Microbiologic patterns were analyzed by time and prophylaxis status.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 195 patients, 88 (45.1%) received FQ prophylaxis. CLABSI rates were 8.0% with prophylaxis versus 15.0% without (\n p<\/jats:italic>\n \u00a0=\u00a00.132), and MBI\u2010LCBI rates were 11.4%\u00a0versus 15.0% (\n p<\/jats:italic>\n \u00a0=\u00a00.463). ICU admission was significantly lower with prophylaxis (10.2%\u00a0vs. 31.8%\n ;<\/jats:bold>\n p<\/jats:italic>\n < 0.001).\n C. difficile<\/jats:italic>\n infection was also less frequent among those receiving prophylaxis (5.7%\u00a0vs. 17.8%;\n p<\/jats:italic>\n \u00a0=\u00a00.012). Neutropenic fever rates were similar between groups. CLABSI isolates were primarily skin flora and staphylococcal species, whereas MBI\u2010LCBI isolates were exclusively enteric flora, increasingly involving Gram\u2010negative rods over time.\n Pseudomonas<\/jats:italic>\n infections were more frequent among patients without prophylaxis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In this cohort, FQ prophylaxis did not significantly reduce bloodstream infections but was associated with fewer ICU admissions and lower rates of\n C. difficile<\/jats:italic>\n infection. These findings further support the use of FQ prophylaxis with minimal concern for exacerbation of\n C. difficile<\/jats:italic>\n rates. It further highlights ongoing risk from enteric translocation despite prophylaxis.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jha2.70225","type":"journal-article","created":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T17:24:35Z","timestamp":1771176275000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fluoroquinolone Prophylaxis Reduces Intensive Care Unit Admission and\n Clostridioides difficile<\/i>\n Rates in Acute Myeloid Leukemia Induction Chemotherapy"],"prefix":"10.1002","volume":"7","author":[{"given":"Charles J.","family":"Weeks","sequence":"first","affiliation":[{"name":"Medical College of Georgia Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujith","family":"Abbagoni","sequence":"additional","affiliation":[{"name":"Medical College of Georgia Augusta Georgia 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