{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T20:36:17Z","timestamp":1768250177860,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,5,16]],"date-time":"2014-05-16T00:00:00Z","timestamp":1400198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Infections remain a leading cause of morbidity and mortality in patients with reduced immunity caused by haematological disease and chemotherapy\u2010induced neutropenia. We evaluated the clinical and microbiological impact of discontinuing fluoroquinolone prophylaxis in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed 154 admissions in three sequential periods of 8\u00a0months: long\u2010standing use, discontinuation of prophylaxis and reintroduction of prophylaxis. Clinical endpoints were occurrence of febrile neutropenia, bacteraemia, severe sepsis, septic shock, response to antibiotic therapy, total antibiotic consumption and duration of hospital stay. Microbiological analysis included bacterial isolates from stool and blood cultures and their resistance pattern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No significant increase in serious infectious complications was seen with the discontinuation of prophylaxis. The overall incidence of bacteraemia did not change, but a higher proportion of bacterial isolates were <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>ram\u2010negative (22.2% vs. 5.9% &amp; 8.6%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.030), more often multisusceptible (50% vs. 0%) and less fluoroquinolone resistant (10% vs. 100%). Screening of stools showed a higher prevalence of organisms in the discontinuation period (86.7% vs. 37.3% &amp; 55.2%; <jats:italic>P<\/jats:italic>\u00a0\u2264\u00a00.001), but they were more frequently multisusceptible (53.8% vs. 10.5% &amp; 6.3%; <jats:italic>P<\/jats:italic>\u00a0\u2264\u00a00.001). After discontinuation of prophylaxis, fluoroquinolone resistance decreased rapidly from 73.7 to 7.7%, in association with a significant decrease in extended spectrum beta\u2010lactamase (<jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>)\u2010producing isolates from 42.1 to 10.3%. Resistance figures immediately returned to prediscontinuation values after reinstitution of prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>No clinically relevant short\u2010term drawbacks were observed with the discontinuation of fluoroquinolone prophylaxis in patients with chemotherapy\u2010induced prolonged profound neutropenia, which led to a significant decrease in fluoroquinolone resistance as well as occurrence of <jats:styled-content style=\"fixed-case\">ESBL<\/jats:styled-content>\u2010producing isolates.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.12345","type":"journal-article","created":{"date-parts":[[2014,4,21]],"date-time":"2014-04-21T15:55:53Z","timestamp":1398095753000},"page":"302-308","source":"Crossref","is-referenced-by-count":30,"title":["Clinical and microbiological impact of discontinuation of fluoroquinolone prophylaxis in patients with prolonged profound neutropenia"],"prefix":"10.1111","volume":"93","author":[{"given":"Anke","family":"Verlinden","sequence":"first","affiliation":[{"name":"Department of Haematology Antwerp University Hospital Edegem Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilde","family":"Jansens","sequence":"additional","affiliation":[{"name":"Department of Infection Control and Microbiology Antwerp University Hospital Edegem Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herman","family":"Goossens","sequence":"additional","affiliation":[{"name":"Department of Infection Control and Microbiology Antwerp University Hospital Edegem Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann L.","family":"van de Velde","sequence":"additional","affiliation":[{"name":"Department of Haematology Antwerp University Hospital Edegem Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilfried A.","family":"Schroyens","sequence":"additional","affiliation":[{"name":"Department of Haematology Antwerp University Hospital Edegem Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zwi N.","family":"Berneman","sequence":"additional","affiliation":[{"name":"Department of Haematology Antwerp University Hospital Edegem Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain P.","family":"Gadisseur","sequence":"additional","affiliation":[{"name":"Department of Haematology Antwerp University Hospital Edegem Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,5,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21847"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2009.01.003"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/152.1.104"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir073"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-12_Part_1-200506210-00008"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044097"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050078"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-007-0397-y"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s150100070019"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11044"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21855"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S11413"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24812"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/152581601317210999"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.254"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2401158"},{"key":"e_1_2_7_18_1","volume-title":"Performance 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