Antibiotic prophylaxis involves the administration of antibiotics prior to any infection in order to prevent infection. Routine antibiotic prophylaxis has been recommended by several professional groups in patients who are at risk for infection, such as those who have an expected duration of severe neutropenia for more than seven days, and patients undergoing hematopoietic cell transplantation (HCT). Flouroquinolones are most often recommended, and have been associated with decreased incidence of febrile neutropenia and infection. Limited evidence exists regarding the use of quinolones in pediatric patients.

Fluoroquinolone antibiotics can increase the risk of ruptures or tears in the aorta for certain patients (U.S. FDA, 2018b). Fluoroquinolone formulations taken by mouth or given by injection can cause certain mental health side effects and blood sugar level disturbances--the low blood sugar levels can lead to coma (U.S. FDA, 2018a). More information can be found at https://www.fda.gov/drugs/drug-safety-and-availability. 

U.S. Food and Drug Administration. (2018a).  FDA reinforces safety information about serious low blood sugar levels and mental health side effects with fluoroquinolone antibiotics; requires label changes. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-reinforces-s… 

U.S. Food and Drug Administration. (2018b). FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-…