Levaquin Gets a Pass: Levofloxacin and Dysbiosis During Intensive Therapy

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: Levofloxacin and Dysbiosis During Intensive Therapy

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

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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.

Original language	English (US)
Pages (from-to)	778-781
Number of pages	4
Journal	Biology of Blood and Marrow Transplantation
Volume	26
Issue number	4
DOIs	https://doi.org/10.1016/j.bbmt.2019.12.722
State	Published - Apr 2020

Bibliographical note

Funding Information:
The authors thank Markas Welke, Carolyn Graiziger, Andrea Hoeschen, and Kevin Olson for coordinating sample collections. Sequence data were processed and analyzed using the resources of the Minnesota Supercomputing Institute. Financial disclosure: A.R. was supported by grants from the University of Minnesota (Medical School Innovation award and Foundation grant for new faculty) and a Marrow on the Move grant from the Division of Hematology, Oncology, and Transplantation. T.K. received partial support from a University of Minnesota Masonic Cancer Center ChainBreaker Grant. This research was also supported by funding from Achieving Cures Together and the Hubbard Broadcasting Foundation. Conflict of interest statement: There are no conflicts of interest to report.

Funding Information:
The authors thank Markas Welke, Carolyn Graiziger, Andrea Hoeschen, and Kevin Olson for coordinating sample collections. Sequence data were processed and analyzed using the resources of the Minnesota Supercomputing Institute. Financial disclosure: A.R. was supported by grants from the University of Minnesota (Medical School Innovation award and Foundation grant for new faculty) and a Marrow on the Move grant from the Division of Hematology, Oncology, and Transplantation. T.K. received partial support from a University of Minnesota Masonic Cancer Center ChainBreaker Grant. This research was also supported by funding from Achieving Cures Together and the Hubbard Broadcasting Foundation. Conflict of interest statement: There are no conflicts of interest to report. Financial disclosure: See Acknowledgments on page 781.

Publisher Copyright:
© 2019 American Society for Transplantation and Cellular Therapy

Keywords

Dysbiosis
Leukemia
Levofloxacin
Microbiota
Transplantation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.bbmt.2019.12.722

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title = "Levaquin Gets a Pass: Levofloxacin and Dysbiosis During Intensive Therapy",

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.",

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note = "Funding Information: The authors thank Markas Welke, Carolyn Graiziger, Andrea Hoeschen, and Kevin Olson for coordinating sample collections. Sequence data were processed and analyzed using the resources of the Minnesota Supercomputing Institute. Financial disclosure: A.R. was supported by grants from the University of Minnesota (Medical School Innovation award and Foundation grant for new faculty) and a Marrow on the Move grant from the Division of Hematology, Oncology, and Transplantation. T.K. received partial support from a University of Minnesota Masonic Cancer Center ChainBreaker Grant. This research was also supported by funding from Achieving Cures Together and the Hubbard Broadcasting Foundation. Conflict of interest statement: There are no conflicts of interest to report. Funding Information: The authors thank Markas Welke, Carolyn Graiziger, Andrea Hoeschen, and Kevin Olson for coordinating sample collections. Sequence data were processed and analyzed using the resources of the Minnesota Supercomputing Institute. Financial disclosure: A.R. was supported by grants from the University of Minnesota (Medical School Innovation award and Foundation grant for new faculty) and a Marrow on the Move grant from the Division of Hematology, Oncology, and Transplantation. T.K. received partial support from a University of Minnesota Masonic Cancer Center ChainBreaker Grant. This research was also supported by funding from Achieving Cures Together and the Hubbard Broadcasting Foundation. Conflict of interest statement: There are no conflicts of interest to report. Financial disclosure: See Acknowledgments on page 781. Publisher Copyright: {\textcopyright} 2019 American Society for Transplantation and Cellular Therapy",

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Levaquin Gets a Pass: Levofloxacin and Dysbiosis During Intensive Therapy

Abstract

Bibliographical note

Keywords

UN SDGs

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