Results from a clinical trial investigating the benefit of giving newly diagnosed myeloma patients antibiotics to prevent infections have recently been reported at the American Society of Haematology 2017 conference.
The aim of the Tackling EArly Morbidity and Mortality in Myeloma (TEAMM) trial was to determine the effect of giving myeloma patients antibiotic prophylaxis (antibiotic treatment given to prevent infections). As myeloma patients have an increased risk of developing infections, it is important to reduce the risk of acquiring infections which can have potentially life-threatening complications.
Patients taking part in this trial were either given a daily dose of an antibiotic known as levofloxacin, or a placebo drug for the first 12 weeks following diagnosis. This was given in addition to anti-myeloma treatments.
The study found that the administration of levofloxacin had a significant benefit. Fewer patients who received the daily dose of levofloxacin showed signs of infection or died within the first 12 weeks following their diagnosis of myeloma, compared to patients who received the placebo.
Another aspect of the trial looked at the effect of antibiotic prophylaxis on the development of antibiotic resistance in myeloma patients.
Prolonged use of antibiotics is often associated with the development of antibiotic resistance. This means that strains of bacteria that cause infection evolve so that antibiotics are no longer effective against them. This can increase the risk of patients developing hospital-acquired infections, such as MRSA and Clostridium difficile, a bacterium that can cause severe diarrhoea.
To assess whether or not levofloxacin increased the risk of carriage of antibiotic-resistant bacteria or invasive infection by these bacteria, patients were regularly tested to see if they were carrying resistant strains of bacteria, including MRSA and Clostridium difficile. The results show that there was no difference between patients receiving levofloxacin and those receiving the placebo, suggesting that antibiotic resistance had not developed.
The results from this trial show that antibiotic prophylaxis with levofloxacin may improve the quality of life and outcomes of newly diagnosed myeloma patients by reducing the risk of infection and early death, without increasing the risk of developing antibiotic resistance and hospital-acquired infections.
For support and information about myeloma, contact the Myeloma Infoline free from the UK on 0800 980 3332 or email AskTheNurse@myeloma.org.uk