Levaquin Gets a Pass

Armin Rashidi; Thomas Kaiser; Shernan G Holtan; Tauseef Ur Rehman; Daniel J Weisdorf; Alexander Khoruts; Christopher Staley

doi:10.1016/j.bbmt.2019.12.722

Levaquin Gets a Pass

Biol Blood Marrow Transplant. 2020 Apr;26(4):778-781. doi: 10.1016/j.bbmt.2019.12.722. Epub 2019 Dec 20.

Authors

Armin Rashidi¹, Thomas Kaiser², Shernan G Holtan³, Tauseef Ur Rehman⁴, Daniel J Weisdorf³, Alexander Khoruts⁵, Christopher Staley²

Affiliations

¹ Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota. Electronic address: arashidi@umn.edu.
² Department of Surgery, University of Minnesota, Minneapolis, Minnesota; BioTechnology Institute, University of Minnesota, St Paul, Minnesota.
³ Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
⁴ Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
⁵ BioTechnology Institute, University of Minnesota, St Paul, Minnesota; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.

PMID: 31870930
DOI: 10.1016/j.bbmt.2019.12.722

Abstract

Antibiotic-induced gut dysbiosis has been associated with poor outcomes after intensive therapy. We evaluated the effect of levofloxacin (LEVO), the most commonly used prophylactic antibacterial antibiotic during intensive chemotherapy and allogeneic hematopoietic cell transplantation (allo-HCT), on the gut microbiota in 2 cohorts of patients, 1 cohort comprising 20 patients with acute leukemia receiving intensive chemotherapy and the other cohort comprising 20 allo-HCT recipients. 16S rRNA gene sequencing of thrice-weekly collected stool samples permitted a comparison between intervals with no antibacterial antibiotic exposure and those with only LEVO exposure. In mixed-effects modeling, the only variables influenced by LEVO were the relative abundances of Parabacteroides (regression coefficient, -.063; 99% confidence interval [CI], -.102 to -.024) and Blautia (regression coefficient, .050; 99% CI, .004 to .095). Other taxa and microbiota diversity were unaffected. Overall, the effect of LEVO on the gut microbiota in these cohorts was mild.

Keywords: Dysbiosis; Leukemia; Levofloxacin; Microbiota; Transplantation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Dysbiosis
Gastrointestinal Microbiome*
Hematopoietic Stem Cell Transplantation*
Humans
Levofloxacin
RNA, Ribosomal, 16S / genetics

Substances

RNA, Ribosomal, 16S
Levofloxacin