NCPA - National Center for Policy Analysis


September 14, 2005

Antibiotics administered to cancer patients whose immune systems are weakened from chemotherapy might prevent some fevers and infections, according to two new studies in the New England Journal of Medicine.

Previous small studies yielded mixed results when doctors tried to head off disease by administering the drugs before illness appeared. The emergence of potentially fatal drug-resistant organisms discouraged such early use, which currently is not recommended, say researchers.

The two new studies, involving 2,325 cancer patients in Italy and Britain, provide the first definitive evidence that antibiotic therapy for the highest-risk patients may ward off infections, prevent fevers and lower hospitalization rates. Consider:

  • In one study, 65 percent of participants with blood cancers or solid tumors who took the antibiotic levofloxacin developed fevers, compared with 85 percent of those who took a placebo.
  • Participants who took levofloxacin also had lower rates of confirmed disease and severe blood infections than those who took a placebo, although the medication did not reduce death rates among participants who received high doses of chemotherapy.
  • Worldwide, about 5 percent of cancer patients with low rates of infection-fighting white blood cells dies from bacterial diseases.

However, Albano del Favero (University of Perugia, Italy), who led one of the studies, says physicians should remain cautious in the use of antibiotics for cancer patients. Treatment should not be standard for all cancer patients before they receive chemotherapy, says del Favero, and its uses should be limited to high-risk patients who may benefit more.

Source: Bloomberg/Arizona Daily Star, "Antibiotics Aid Patients on Chemo," September 9, 2005; Giampaolo Bucaneve et al, "Levofloxacin to Prevent Bacterial Infection in Patients with Cancer and Neutropenia," New England Journal of Medicine, Vol. 353:977-987, No. 10, September 8, 2005; and Michael Cullen et al, "Antibacterial Prophylaxis after Chemotherapy for Solid Tumors and Lymphomas," New England Journal of Medicine, Vol. 353:988-998, No. 10, September 9, 2005.

For Bucaneve study:

For Cullen study:


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