Antimicrobial prophylaxis in pediatric patients with leukemia: Reducing incidence of febrile neutropenia episodes and bloodborne infections

Introduction Infectious complications are a leading cause of morbidity and mortality in pediatric leukemia, particularly during intensive chemotherapy. Febrile neutropenia (FN), bacteremia, and fungemia are common and potentially life-threatening. This study evaluated the effectiveness of antimicrobial prophylaxis in preventing infectious complications in pediatric patients with leukemia. Methods A retrospective, matched chart review was conducted involving 182 pediatric patients (aged 1–18 years) diagnosed with leukemia. Patients were stratified based on receipt of antimicrobial prophylaxis, Levofloxacin, Caspofungin, Fluconazole, or a combination (n = 40), versus no prophylaxis (n = 64). Primary outcomes included the number of FN episodes, bacteremia, and fungemia. Results Patients who received antimicrobial prophylaxis experienced significantly fewer FN episodes and bacteremia events compared to those who did not receive prophylaxis. No cases of increased antimicrobial resistance were observed in the prophylaxis group. Rates of fungemia were low in both groups. Conclusions Antimicrobial prophylaxis during high-risk phases of chemotherapy is associated with reduced FN and bacteremia in pediatric leukemia patients. These findings support its implementation as a preventative strategy in HR patients to reduce infectious complications without increasing antimicrobial resistance.