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

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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 languageEnglish (US)
Pages (from-to)778-781
Number of pages4
JournalBiology of Blood and Marrow Transplantation
Issue number4
StatePublished - Apr 2020


  • Dysbiosis
  • Leukemia
  • Levofloxacin
  • Microbiota
  • Transplantation

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't

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