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Antibiotic prophylaxis for patients with newly diagnosed multiple myeloma: Systematic review and meta‐analysis
Author(s) -
Mohyuddin Ghulam Rehman,
Aziz Muhammad,
McClune Brian,
Abdallah AlOla,
Qazilbash Muzaffar
Publication year - 2020
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13374
Subject(s) - antibiotics , medicine , incidence (geometry) , meta analysis , antibiotic prophylaxis , placebo , relative risk , multiple myeloma , clinical trial , intensive care medicine , confidence interval , pathology , alternative medicine , physics , optics , microbiology and biotechnology , biology
Abstract Objective Ascertain the benefit of prophylactic antibiotics for patients with newly diagnosed multiple myeloma (MM), given that clinical trials evaluating this have had conflicting results. Methods We performed a systematic review and meta‐analysis evaluating the use of prophylactic antibiotics in patients with MM and its impact on infection risk and mortality. Results Across three included studies, a total of 664 patients received antibiotics and 650 patients received no antibiotics. The overall incidence of infection within 3 months was lower for antibiotic group compared to placebo (18.4% vs 23.4%, RR: 0.79, 95% CI 0.62‐1.00, P = .05, I 2 = 6.5%). There was no difference in mortality in the first 3 months (1.5% vs 3.5%, RR: 0.47, 95% CI 0.17‐1.27, P = .60, I 2 = 28.1%). Conclusion Antibiotic prophylaxis for a finite duration can decrease the overall incidence of infection within the first 3 months following diagnosis. This does not lead to a decrease in mortality. Further data on antibiotic resistance patterns, toxicity, healthcare expenditures, and the impact of antibiotics on subsequent therapies can assist providers in helping make decisions on prophylactic antibiotics with their patients.