Levofloxacin Usage

[Norman Schwartz]

I have the following diagnosis:
• Low risk Myelodysplastic syndrome with multilineage dysplasia (MDS-MLD)
• Hypercellular bone marrow (70% cellular) with trilineage dyspoiesis of variable degree
• 12 -15 % ring sideroblasts
• 2% blasts
• Slight to moderate reticulin fibrosis
• Pancytopenia
OncoHeme Next Generation Sequencing for Myeloid Neoplasms yielded:
• CBL: c.1211G>A; p.Cys404Tyr (43%)
• IDH1: c.395G>A; p.Arg132His (42%)
• SRSF2: c.284_307del; p.Pro95_Arg102del (52%)
• RUNX1: c.359C>T; p.Ala120Val (48%)
Treatment: Supportive care reasonable for now, while advising that an antibiotic prophylaxis with Levofloxacin for Neutropenia is available as an option.
Question: My personal research suggests that Levofloxacin, when administered as a remedy for upper respiratory bacterial infection, is typically limited to 10 – 14 days usage. When administered as a prophylaxis for a Neutropenia condition, what is the recommended usage duration?
My concern is the development of antibiotic resistance over time and the development of C. difficile infection. Daily ingestion of yogurt with live and active culture was instructed if the Levofloxacin option is exercised.
Would another choice of antibiotic be more advantageous as a prophylaxis relative to my diagnosis? Alternatively, would it be best at this early stage of my condition to only administer Levofloxacin as a treatment if and when a bacterial infection materializes?
Thank you for your advice/opinions regarding this matter.

[Ashley Moncrief]

Good morning,

Levofloxacin is commonly used as prophylaxis in patients with MDS who have low neutrophil counts; however, there are other options for people who cannot take it. When given prophylactically, it is taken daily. There is not necessarily a set time frame for stopping because it is typically based on blood counts and that is different for everyone. I would definitely talk to your doctor about your concerns and blood counts so you can work together to make the best decision. Hope this helps!

Ashley Moncrief

[Norman Schwartz]

Thank you Ashley for your response. This second source of information is helpful in alleviating my concerns. I will discuss this further with my doctor to also consider alternatives as you indicated. Thank you once again.
Norman Schwartz

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